| NPI | 1598399370 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JO-ANN PRISCO VP Of Contracts 772-216-3031 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2020-03-02 |
| Last Update Date | 2024-04-23 |