| NPI | 1154773646 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VERONICE RENEE' GANT Owner 228-326-8059 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management (Licence: AL 104034) |
| Additional Taxonomies | 251B00000X Case Management (Licence: MS 1087186) |
| 251B00000X Case Management (Licence: TX 802412348) | |
| Enumeration Date | 2016-07-07 |
| Last Update Date | 2016-07-07 |