| NPI | 1154835155 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BLESSING CORDILIA EGEDE Program Administrator 469-358-5196 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2017-11-29 |
| Last Update Date | 2017-11-29 |