| NPI | 1508103441 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMIKA PURNELL CEO 267-597-7323 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251E00000X Home Health |
| 302R00000X Health Maintenance Organization | |
| Enumeration Date | 2013-01-11 |
| Last Update Date | 2013-01-11 |