| NPI | 1659006146 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELINE LORRAINE LOUISSAINT Vice President 833-472-6274 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 251B00000X Case Management | |
| 251S00000X | |
| 261QA0600X Clinic/Center, Adult Day Care | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QR0400X Clinic/Center, Rehabilitation | |
| 332800000X Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | |
| Enumeration Date | 2022-07-19 |
| Last Update Date | 2022-07-19 |