| NPI | 1366181554 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAKISHA HOOPER Qmhp 346-419-7424 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 251B00000X Case Management | |
| Enumeration Date | 2022-06-03 |
| Last Update Date | 2023-08-30 |