| NPI | 1902056799 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HUMBERTO DE LA CRUZ Executive Director 267-975-2025 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: PA 133910) |
| Enumeration Date | 2008-09-29 |
| Last Update Date | 2008-10-16 |