NPI | 1609249697 |
---|---|
Entity Type | Organization |
Authorized Contact | BYESHEBA ENTZMINGER-BULLOCK Owner/Administrator 571-403-9871 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X Community/Behavioral Health |
Enumeration Date | 2015-11-12 |
Last Update Date | 2015-11-12 |