| NPI | 1851114003 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUANITA MICHELLE PATINO Director Of Operations 833-626-8724 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2024-11-06 |
| Last Update Date | 2025-11-20 |