| NPI | 1073647905 |
|---|---|
| Doing Business As | NORTH JEFFERSON ST ANNEX |
| Entity Type | Organization |
| Authorized Contact | ROBERT KEITH MORAN CFO 478-272-1190 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2020-08-22 |