| NPI | 1104131457 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LANINIA DEAMER Executive Director 980-201-0005 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2010-08-11 |
| Last Update Date | 2024-02-20 |