| NPI | 1295140036 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE SANDER-GRAY Manager 1262-527-1282 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2014-06-30 |
| Last Update Date | 2014-06-30 |