| NPI | 1821294646 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEON MICHEAL WILSON President 703-915-9526 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: MD LC1652) |
| Additional Taxonomies | 302R00000X Health Maintenance Organization (Licence: TX 63213) |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2007-09-24 |