| NPI | 1073965828 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMAL-KALEE FERGUSON Chief Executive Officer 267-767-0662 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2016-07-05 |
| Last Update Date | 2020-07-14 |