| NPI | 1740652395 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENI CHARISSE BOWEN Member 205-765-7565 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AL 2809) |
| Enumeration Date | 2015-10-22 |
| Last Update Date | 2015-10-22 |