| NPI | 1396015509 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JIM WEISS Director Of Quality Management 877-592-5901 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2012-01-04 |
| Last Update Date | 2012-01-04 |