| NPI | 1811648165 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLODIE MOTANGA Clinical Case Manager 800-993-3620 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 104100000X Social Worker |
| Enumeration Date | 2022-01-18 |
| Last Update Date | 2022-01-18 |