| NPI | 1770867004 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIRIAM ALICE TOWNSEND Director 267-639-7748 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor Mental Health | |
| 101YP1600X Counselor Pastoral | |
| 101YS0200X Counselor School | |
| 102X00000X Poetry Therapist | |
| 103T00000X Psychologist | |
| 103TB0200X Psychologist Cognitive & Behavioral | |
| 103TE1100X Psychologist Exercise & Sports | |
| 1041S0200X Social Worker School | |
| 174H00000X Health Educator | |
| 251K00000X Public Health or Welfare | |
| 252Y00000X Early Intervention Provider Agency | |
| 253Z00000X In Home Supportive Care | |
| 310500000X Intermediate Care Facility, Mental Illness | |
| Enumeration Date | 2011-10-05 |
| Last Update Date | 2011-10-05 |