| NPI | 1033503602 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHENICKEA GODFREY CEO 877-460-7009 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management |
| Additional Taxonomies | 246RP1900X Technician, Pathology, Phlebotomy |
| 251C00000X Day Training, Developmentally Disabled Services | |
| 305S00000X Point of Service | |
| Enumeration Date | 2015-03-23 |
| Last Update Date | 2015-03-23 |