| NPI | 1821471723 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALISON GRACE HAMPTON Owner 251-604-0152 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AL 3097) |
| Enumeration Date | 2015-07-09 |
| Last Update Date | 2015-07-09 |