| NPI | 1801180443 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH RYDELL OWENS Secretary 757-778-5787 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: VA S352074-1) |
| Enumeration Date | 2011-05-31 |
| Last Update Date | 2011-05-31 |