| NPI | 1871461533 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KISHA MONTGOMERY Director 346-328-2879 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 251B00000X Case Management |
| Enumeration Date | 2025-10-24 |
| Last Update Date | 2025-10-24 |