| NPI | 1770426504 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA MECHELLE RUSSELL Owner 470-205-9882 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251X00000X Supports Brokerage |
| Additional Taxonomies | 251B00000X Case Management |
| Enumeration Date | 2026-04-14 |
| Last Update Date | 2026-04-14 |