| NPI | 1245652031 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MYRNA F MOXHAM Owner 302-324-5255 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: DE 2011605393) |
| Enumeration Date | 2014-01-13 |
| Last Update Date | 2014-01-13 |