| NPI | 1891374930 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA ANN TESTER Owner/Executive Director 567-201-2048 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2021-04-06 |
| Last Update Date | 2021-04-06 |