| NPI | 1063145787 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHIYAH POLK Co Founder 228-731-5156 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2022-07-09 |
| Last Update Date | 2022-07-09 |