NPI | 1346840261 |
---|---|
Entity Type | Organization |
Authorized Contact | JALISA PRECIOUS JACKSON Director 980-258-2704 |
Organization Subpart ? | No |
Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
Enumeration Date | 2020-10-29 |
Last Update Date | 2020-10-29 |