| NPI | 1982262184 |
|---|---|
| Former Legal Business Name | CONCLAVE MEDIA LLC |
| Entity Type | Organization |
| Authorized Contact | DAVID SANTANA Owner, CEO 754-801-6404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Enumeration Date | 2019-06-03 |
| Last Update Date | 2020-10-22 |