| NPI | 1467123612 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARNESHIA R SUMMERVILLE Owner (Care Coordinator 262-202-2014 |
| Organization Subpart ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Enumeration Date | 2021-09-27 |
| Last Update Date | 2021-09-27 |