| NPI | 1386467017 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRAPETA B MAYSON Interim Chief Executive Officer 267-541-9204 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2024-11-01 |
| Last Update Date | 2024-11-01 |