| NPI | 1497159149 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JO ANN REEVES ELLIOTT Owner Of LLC 205-767-2367 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AL 2602) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: FL MH8187) |
| Enumeration Date | 2014-10-09 |
| Last Update Date | 2014-10-16 |