NPI | 1003697798 |
---|---|
Entity Type | Organization |
Authorized Contact | RALPH KENNETH MCCOY Owner/Executive Director 267-709-1186 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X Community/Behavioral Health |
Enumeration Date | 2023-10-10 |
Last Update Date | 2023-10-10 |