| NPI | 1912560616 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DESIREE CORLEY JONES CEO 888-763-7837 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 251B00000X Case Management |
| 251C00000X Day Training, Developmentally Disabled Services | |
| 252Y00000X Early Intervention Provider Agency | |
| 261QD1600X Clinic/Center, Developmental Disabilities | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2019-04-17 |
| Last Update Date | 2021-07-27 |