| NPI | 1962871798 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANNY WAMSLEY Owner 919-917-0609 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 302R00000X Health Maintenance Organization |
| 305S00000X Point of Service | |
| Enumeration Date | 2015-09-22 |
| Last Update Date | 2017-02-16 |