| NPI | 1609337948 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LENARD ANDERSON Managing Partner 346-237-4282 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management |
| Additional Taxonomies | 251S00000X |
| 261QC1500X Clinic/Center, Community Health | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2019-03-28 |
| Last Update Date | 2019-10-24 |