NPI | 1669769543 |
---|---|
Entity Type | Organization |
Authorized Contact | AALYSHA MICHELLE GONZALEZ President 918-740-0393 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL MH9697) |
Enumeration Date | 2011-06-29 |
Last Update Date | 2011-06-29 |