| NPI | 1003477456 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACEY LYNN MULLINS Owner 346-288-0085 |
| Organization Subpart ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 251B00000X Case Management |
| 251C00000X Day Training, Developmentally Disabled Services | |
| 251S00000X Community/Behavioral Health | |
| 253Z00000X In Home Supportive Care | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2019-06-26 |
| Last Update Date | 2019-06-26 |