| NPI | 1700021441 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLA JOANNE HANNAH Provider 469-835-6428 |
| Organization Subpart ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator (Licence: TX 835552) |
| Enumeration Date | 2008-12-09 |
| Last Update Date | 2008-12-09 |