| NPI | 1538708896 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADEOLA TEMITOPE SOTUBO Program Administrator 667-240-5881 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2020-01-03 |
| Last Update Date | 2020-01-03 |