| NPI | 1609588995 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MASON JACOB WARE Owner 701-212-7106 |
| Organization Subpart ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 175T00000X Peer Specialist |
| Enumeration Date | 2022-12-19 |
| Last Update Date | 2022-12-19 |