| NPI | 1932640588 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIE MIRNA LEXIMA Owner/Administrator 571-332-8353 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: VA 0001152672) |
| Additional Taxonomies | 251300000X Local Education Agency (LEA) (Licence: VA 0001152672) |
| 251J00000X Nursing Care (Licence: VA 0001152672) | |
| Enumeration Date | 2017-03-15 |
| Last Update Date | 2017-03-15 |