| NPI | 1245809904 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAUREN E HOLLY Chief Operating Officer 234-417-0250 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA0600X Clinic/Center, Adult Day Care |
| Enumeration Date | 2021-06-17 |
| Last Update Date | 2021-06-17 |