| NPI | 1598212326 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARMELLA NICOLE O'NEAL Owner 256-433-9273 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IN 35001854A) |
| Enumeration Date | 2016-09-09 |
| Last Update Date | 2016-09-09 |