| NPI | 1790507028 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHYLLIS TELLIS Community Health Worker Ii 469-584-0824 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 1041C0700X Social Worker, Clinical | |
| 171400000X Health & Wellness Coach | |
| 172V00000X Community Health Worker | |
| 251B00000X Case Management | |
| 374J00000X Doula | |
| Enumeration Date | 2024-10-28 |
| Last Update Date | 2025-05-05 |