| NPI | 1386715589 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLORIA ONEAL JACKSON Senior Mental Health Counselor RN 800-854-7771 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: CA 122033) |
| Enumeration Date | 2006-11-11 |
| Last Update Date | 2020-08-22 |