NPI | 1871192427 |
---|---|
Entity Type | Organization |
Authorized Contact | KAYLEE KATHRYN VANCE Director Of Utilization Management 386-668-4774 |
Organization Subpart ? | Yes |
Primary Taxonomy | 251S00000X Community/Behavioral Health |
Enumeration Date | 2020-10-23 |
Last Update Date | 2020-10-23 |