| NPI | 1790150845 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHERINE NORRIS General Counsel 888-364-5977 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: WA SC60568851) |
| Additional Taxonomies | 251S00000X (Licence: WA CG60597169) |
| Enumeration Date | 2015-12-01 |
| Last Update Date | 2022-10-11 |