| NPI | 1184096950 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANTERIA ONYEMEM Program Director 346-754-3490 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA0600X Clinic/Center Adult Day Care |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2015-10-20 |
| Last Update Date | 2023-11-12 |