| NPI | 1528545340 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARQUITA RUSSELL Admin 980-258-9315 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 104100000X Social Worker |
| 251B00000X Case Management | |
| Enumeration Date | 2018-07-24 |
| Last Update Date | 2018-08-08 |