| NPI | 1790534105 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SOLANGE MATCHOUABOU Administrator 214-487-4007 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization |
| Additional Taxonomies | 251E00000X Home Health |
| Enumeration Date | 2024-05-16 |
| Last Update Date | 2024-05-16 |