| NPI | 1972307072 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON J ROSENSWEIG Mgrm 800-906-5194 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 251E00000X Home Health |
| 261Q00000X Clinic/Center | |
| 261QH0100X Clinic/Center Health Service | |
| 320700000X Residential Treatment Facility, Physical Disabilities | |
| Enumeration Date | 2025-04-01 |
| Last Update Date | 2025-04-07 |