| NPI | 1891837613 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL PRICE Director Of Operations 800-616-3718 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: OH pn058001) |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2020-08-22 |