Organization Name: | WITHROW OUT A TRACE MINISTYR |
NPI Number: | 1235371352 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | VINCENT M DUGAN (COUNSELOR) |
Mailing Address: | 2110 Artesia Blvd Redondo Beach |
State: | CA US |
Postal Code: | 902783073 |
Phone Number: | 3105695868 |
Fax Number: | |
NPI Enumeration Date: | 04/03/2009 |
NPI Last Update Date: | 04/03/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 302R00000X |
License Number: | RW2056 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Managed Care Organizations |
Taxonomy Classification: | Health Maintenance Organization |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) A form of health insurance in which its members prepay a premium for the HMO |