| NPI | 1962219675 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA WEST Credentialing COO Rdinator 234-542-6044 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QA0005X Clinic/Center Ambulatory Family Planning Facility |
| Enumeration Date | 2024-12-16 |
| Last Update Date | 2025-01-27 |