| NPI | 1255220711 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUKMINI ALONZO President 862-576-4888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 251B00000X Case Management |
| 251S00000X Community/Behavioral Health | |
| 261QC1500X Clinic/Center, Community Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| 322D00000X Residential Treatment Facility, Emotionally Disturbed Children | |
| 347C00000X Private Vehicle | |
| Enumeration Date | 2025-06-30 |
| Last Update Date | 2025-06-30 |