| NPI | 1831722529 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEJANDRO J CASTRO Organization Director 844-593-2160 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2020-02-20 |
| Last Update Date | 2023-03-17 |