| NPI | 1124713268 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRAYCEEA RAY Licensed Certified Social Worker 662-588-0025 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2023-04-05 |
| Last Update Date | 2023-04-05 |