| NPI | 1841594108 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STAN LONG Sole Proprietor 256-270-9970 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AL 0872-2147C) |
| Enumeration Date | 2010-12-30 |
| Last Update Date | 2010-12-30 |