| NPI | 1639231012 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COURTNEY DIANE OWEN Program Officer 267-838-1462 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 1041C0700X Social Worker Clinical |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2024-07-12 |