| NPI | 1699373415 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLETTE A GREEN Senior Director Of Programs 267-322-0938 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2020-10-14 |
| Last Update Date | 2020-10-14 |