NPI | 1033521026 |
---|---|
Entity Type | Organization |
Authorized Contact | JODI L OLMSTEAD Owner 772-224-1294 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL LM12574) |
Enumeration Date | 2014-05-24 |
Last Update Date | 2014-05-24 |