| NPI | 1437029014 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICAH MOORE Social Worker 472-218-9733 |
| Organization Subpart ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2025-11-07 |
| Last Update Date | 2025-11-07 |