| NPI | 1790507028 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHYLLIS TELLIS Community Health Worker 469-584-0824 |
| Organization Subpart ? | No |
| Primary Taxonomy | 172V00000X Community Health Worker |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103K00000X Behavior Analyst | |
| 1041C0700X Social Worker, Clinical | |
| 106S00000X Behavior Technician | |
| 171400000X Health & Wellness Coach | |
| 174400000X Specialist | |
| 175T00000X Peer Specialist | |
| 208U00000X Clinical Pharmacology | |
| 261QC1500X Clinic/Center, Community Health | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| 363LP0200X Nurse Practitioner, Pediatrics | |
| 374J00000X Doula | |
| Enumeration Date | 2024-10-28 |
| Last Update Date | 2025-08-06 |