| NPI | 1245122811 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELTON WATSON CEO 929-360-6515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| 251B00000X Case Management | |
| 251E00000X Home Health | |
| 252Y00000X Early Intervention Provider Agency | |
| 253J00000X Foster Care Agency | |
| 261QA0600X Clinic/Center, Adult Day Care | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 261QR0400X Clinic/Center, Rehabilitation | |
| 310400000X Assisted Living Facility | |
| 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness | |
| 310500000X Intermediate Care Facility, Mental Illness | |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2025-07-17 |
| Last Update Date | 2025-08-09 |