| NPI | 1639862576 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHEYENNE DOSS CEO 470-424-2818 |
| Organization Subpart ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| Enumeration Date | 2023-05-26 |
| Last Update Date | 2024-02-08 |