| NPI | 1245065705 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TASHIRA JOHNSON Director 346-977-0110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness | |
| Enumeration Date | 2024-09-04 |
| Last Update Date | 2024-09-04 |