| NPI | 1659738623 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEMETRIA GAYLE WALLACE Director Case Management Program 1866-386-8404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management |
| Enumeration Date | 2016-01-21 |
| Last Update Date | 2016-01-21 |