| NPI | 1184246712 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIWANA FAYE FUSELIER Owner 346-600-3564 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 251S00000X |
| 253Z00000X In Home Supportive Care | |
| 310500000X Intermediate Care Facility, Mental Illness | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| 385H00000X Respite Care | |
| Enumeration Date | 2020-05-18 |
| Last Update Date | 2024-04-09 |