| NPI | 1639794126 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWNIKA BLATE Administrator 332-255-7113 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2020-06-10 |
| Last Update Date | 2020-06-10 |