| NPI | 1912640129 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DRESEAN MATTHEWS Owner 866-226-1031 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 174200000X Meals |
| 177F00000X Lodging | |
| 251B00000X Case Management | |
| 253J00000X Foster Care Agency | |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| 261QM0850X Clinic/Center Adult Mental Health | |
| 3336M0002X Pharmacy Mail Order Pharmacy | |
| Enumeration Date | 2022-04-15 |
| Last Update Date | 2022-05-06 |