| NPI | 1689261083 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALESIA CARLOCK Owner 224-229-2029 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 251B00000X Case Management |
| 251K00000X Public Health or Welfare | |
| 251V00000X Voluntary or Charitable | |
| Enumeration Date | 2020-12-31 |
| Last Update Date | 2022-03-07 |