NPI | 1962427971 |
---|---|
Entity Type | Organization |
Authorized Contact | LISA KEETER Cbo Manager 706-812-4206 |
Organization Subpart ? | No |
Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: GA 416) |
Enumeration Date | 2006-07-12 |
Last Update Date | 2020-08-22 |