| NPI | 1801610241 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | JERONE BRACEY COO 346-529-7822 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 251S00000X Community/Behavioral Health | 
| Additional Taxonomies | 251B00000X Case Management | 
| Enumeration Date | 2024-11-12 | 
| Last Update Date | 2024-12-25 |