| NPI | 1538870001 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELLYANN MOORE HINES THOMAS Owner/ Director 754-400-1689 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2022-12-06 |
| Last Update Date | 2022-12-06 |