| NPI | 1508389651 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENNIS E. COOK President & Cep 267-940-5006 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 261QC1500X Clinic/Center, Community Health | |
| 261QD1600X Clinic/Center, Developmental Disabilities | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 385HR2055X Respite Care, Respite Care, Mental Illness, Child | |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| Enumeration Date | 2017-07-20 |
| Last Update Date | 2017-07-20 |