| NPI | 1104798552 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANEIDRA GARY President 346-482-2228 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 177F00000X Lodging |
| 251B00000X Case Management | |
| 251V00000X Voluntary or Charitable | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 310400000X Assisted Living Facility | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| 174200000X Meals | |
| Enumeration Date | 2025-09-23 |
| Last Update Date | 2025-09-23 |