| NPI | 1932835360 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL PAUL BAGBY Ambr 727-415-2308 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 251E00000X Home Health | |
| 261QG0250X Clinic/Center, Genetics | |
| 261QH0100X Clinic/Center, Health Services | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 261QP2300X Clinic/Center, Primary Care | |
| 261QR1100X Clinic/Center, Research | |
| Enumeration Date | 2022-07-27 |
| Last Update Date | 2022-07-27 |