| NPI | 1114458189 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | APRIL K LATSON Owner 347-869-4897 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MD 22118) |
| Additional Taxonomies | 251B00000X Case Management (Licence: MD 22118) |
| Enumeration Date | 2017-03-22 |
| Last Update Date | 2017-03-22 |