NPI | 1609284652 |
---|---|
Entity Type | Organization |
Authorized Contact | KALI HEIMBACH Owner 267-597-1029 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL 1-13-15004) |
Enumeration Date | 2014-07-22 |
Last Update Date | 2014-07-22 |