NPI | 1588490650 |
---|---|
Entity Type | Organization |
Authorized Contact | TIFFANY BLAKE Owner 346-300-6131 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
Additional Taxonomies | 251B00000X Case Management |
171M00000X Case Manager/Care Coordinator | |
320800000X Community Based Residential Treatment Facility, Mental Illness | |
251S00000X Community/Behavioral Health | |
Enumeration Date | 2024-09-13 |
Last Update Date | 2025-10-03 |