| NPI | 1922767250 |
|---|---|
| Doing Business As | IMMORTELLE MED |
| Entity Type | Organization |
| Authorized Contact | JESSICA JACOBSON Owner/President 424-355-9023 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health |
| Enumeration Date | 2021-12-14 |
| Last Update Date | 2021-12-14 |