| NPI | 1255811667 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY HERDMAN IVINS Chief Administrative Officer 568-651-7553 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2018-08-15 |
| Last Update Date | 2022-12-01 |