| NPI | 1417308941 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELAN PENDLETON Executive Director 267-275-2393 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: PA 6417465) |
| Additional Taxonomies | 251B00000X Case Management |
| 252Y00000X Early Intervention Provider Agency | |
| Enumeration Date | 2016-06-27 |
| Last Update Date | 2016-07-11 |