| NPI | 1710381579 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA WOLANZYK Owner/Provider 256-278-4364 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AL 2351c) |
| Enumeration Date | 2014-10-22 |
| Last Update Date | 2014-10-22 |