NPI | 1841677911 |
---|---|
Entity Type | Organization |
Authorized Contact | DOMINIC IRABOR Registered Nurse 651-334-2100 |
Organization Subpart ? | No |
Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: MN 1077537-1-HCBS) |
Additional Taxonomies | 302R00000X Health Maintenance Organization (Licence: MN 1077537) |
Enumeration Date | 2015-04-28 |
Last Update Date | 2016-06-28 |