| NPI | 1073872578 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY L. WILLIAMS Chief Executive Officer 754-204-2025 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 251B00000X Case Management |
| 305S00000X Point of Service | |
| Enumeration Date | 2012-05-04 |
| Last Update Date | 2012-05-04 |