| NPI | 1184180218 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY BROOKS PRICE Operations Director 667-309-3063 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2019-02-13 |
| Last Update Date | 2019-02-13 |