| NPI | 1649065129 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NIKEDA STANBACK Owner 267-574-2457 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2025-04-14 |
| Last Update Date | 2025-04-14 |