| NPI | 1306123674 |
|---|---|
| Doing Business As | N/A |
| Entity Type | Organization |
| Authorized Contact | LUCY W. GALLON Director 334-312-3034 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2011-11-14 |
| Last Update Date | 2011-11-14 |