| NPI | 1437624814 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESA ANN WADDELL Executive Director 844-473-6378 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 251B00000X Case Management |
| 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| 261QM0850X Clinic/Center Adult Mental Health | |
| 261QM1300X Clinic/Center Multi-Specialty | |
| 171M00000X Case Manager/Care Coordinator | |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| 3245S0500X Substance Abuse Rehabilitation Facility Substance Abuse Treatment, Children | |
| 175T00000X Peer Specialist | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2018-10-11 |
| Last Update Date | 2025-09-30 |