| NPI | 1487170759 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIRGINIA POUGH Director Of Operation 980-505-0902 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2017-08-18 |
| Last Update Date | 2022-07-21 |