| NPI | 1255844601 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE BLACKSTOCK Case Manager/Care Coordinator 267-975-8965 |
| Organization Subpart ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 251B00000X Case Management |
| Enumeration Date | 2017-11-08 |
| Last Update Date | 2017-11-08 |