| NPI | 1508360892 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAUKURA MANDISA BROWN CEO 980-263-0991 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 251B00000X Case Management |
| 251C00000X Day Training, Developmentally Disabled Services | |
| 251S00000X | |
| 251V00000X Voluntary or Charitable | |
| 261QA0600X Clinic/Center, Adult Day Care | |
| 261QD1600X Clinic/Center, Developmental Disabilities | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 261QP0904X Clinic/Center, Public Health, Federal | |
| 261QP0905X Clinic/Center, Public Health, State or Local | |
| 261QP2000X Clinic/Center, Physical Therapy | |
| 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children | |
| 385HR2050X Respite Care, Respite Care Camp | |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| Enumeration Date | 2018-03-21 |
| Last Update Date | 2021-09-02 |