| NPI | 1154838399 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLIE W SMITH Sole Proprietor 256-684-2462 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AL 2587) |
| Enumeration Date | 2018-01-09 |
| Last Update Date | 2018-03-17 |