| NPI | 1790411445 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAVARES ALLEN GARRETT Certified Nutrition Coach 818-813-4300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 261QH0100X Clinic/Center, Health Services | |
| Enumeration Date | 2022-07-26 |
| Last Update Date | 2022-07-26 |