| NPI | 1376368043 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELANIE REGINA THRASHER- IGORI Dirctor 469-379-7405 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness |
| Additional Taxonomies | 251B00000X Case Management |
| 251C00000X Day Training, Developmentally Disabled Services | |
| 261QA0600X Clinic/Center, Adult Day Care | |
| 261QD1600X Clinic/Center, Developmental Disabilities | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 310400000X Assisted Living Facility | |
| 310500000X Intermediate Care Facility, Mental Illness | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| 347E00000X Transportation Broker | |
| Enumeration Date | 2024-11-18 |
| Last Update Date | 2024-11-18 |