NPI | 1063002079 |
---|---|
Entity Type | Organization |
Authorized Contact | DICKSON IDUSUYI CEO 225-610-5376 |
Organization Subpart ? | No |
Primary Taxonomy | 251B00000X Case Management |
Additional Taxonomies | 251S00000X Community/Behavioral Health |
320800000X Community Based Residential Treatment Facility, Mental Illness | |
Enumeration Date | 2021-01-23 |
Last Update Date | 2024-09-26 |