| NPI | 1013117720 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LA TANYA DENICE HARDY CEO 866-495-3651 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 251B00000X Case Management |
| 253J00000X Foster Care Agency | |
| 261QC1500X Clinic/Center Community Health | |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| 261QM1300X Clinic/Center Multi-Specialty | |
| 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder | |
| 3245S0500X Substance Abuse Rehabilitation Facility Substance Abuse Treatment, Children | |
| Enumeration Date | 2007-07-20 |
| Last Update Date | 2024-03-06 |