| NPI | 1912140484 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONICA ANGEL LOGAN CEO 678-894-0288 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 208000000X Pediatrics | |
| 341600000X Ambulance | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| Enumeration Date | 2009-04-14 |
| Last Update Date | 2021-08-31 |