| NPI | 1912664350 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAKESHA JONES Provider 951-212-2221 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251J00000X Nursing Care |
| Additional Taxonomies | 261QH0100X Clinic/Center Health Service |
| 305S00000X Point of Service | |
| Enumeration Date | 2021-11-19 |
| Last Update Date | 2021-11-19 |