| NPI | 1174120513 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANNETTA V MONTISSOL CEO 857-204-6773 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 163WH0200X Registered Nurse Home Health |
| 251E00000X Home Health | |
| 261Q00000X Clinic/Center | |
| 363LF0000X Nurse Practitioner Family | |
| 374U00000X Home Health Aide | |
| Enumeration Date | 2020-10-08 |
| Last Update Date | 2020-10-08 |