| NPI | 1710701628 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHANCE CANNON Owner 980-252-0038 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 174200000X Meals |
| 251B00000X Case Management | |
| 251C00000X Day Training, Developmentally Disabled Services | |
| 251E00000X Home Health | |
| 253J00000X Foster Care Agency | |
| 253Z00000X In Home Supportive Care | |
| 261Q00000X Clinic/Center | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| 347E00000X Transportation Broker | |
| Enumeration Date | 2024-11-08 |
| Last Update Date | 2025-02-23 |