| NPI | 1841475225 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK ROBERT STONICH Director Of Nursing 267-319-1530 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2008-01-04 |
| Last Update Date | 2010-08-17 |