| NPI | 1619367265 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA LYNN MONTGOMERY Administrative & Fiscal Manager 385-468-3183 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management |
| Enumeration Date | 2015-02-03 |
| Last Update Date | 2015-02-03 |