| NPI | 1376326850 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOVAKYSHE WOULLARD Program Director 800-470-8303 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 171M00000X Case Manager/Care Coordinator | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2023-08-17 |
| Last Update Date | 2024-06-20 |