| NPI | 1346596798 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VONTIA ANITA JONES Owner/President 267-266-2784 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 343900000X Non-emergency Medical Transport (VAN) |
| 302F00000X Exclusive Provider Organization | |
| 251B00000X Case Management | |
| 253J00000X Foster Care Agency | |
| 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children | |
| Enumeration Date | 2012-08-02 |
| Last Update Date | 2014-04-29 |