| NPI | 1881174183 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLORIA THORA JOHNSON APPLETON Executive Director 862-252-3589 |
| Organization Subpart ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Enumeration Date | 2018-08-16 |
| Last Update Date | 2018-08-16 |