| NPI | 1093245417 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARQUITTA RUSSELL Agency Administrator 980-258-9315 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 104100000X Social Worker | |
| 171M00000X Case Manager/Care Coordinator | |
| 175T00000X Peer Specialist | |
| 251B00000X Case Management | |
| 253Z00000X In Home Supportive Care | |
| Enumeration Date | 2017-06-18 |
| Last Update Date | 2023-11-15 |