| NPI | 1891155362 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DELMA GREY Administrator 239-369-2624 |
| Organization Subpart ? | No |
| Primary Taxonomy | 172V00000X Community Health Worker (Licence: FL 6906816) |
| Enumeration Date | 2016-02-26 |
| Last Update Date | 2016-02-26 |