| NPI | 1942736681 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | APRIL RENEE CRABLE Owner 434-637-5081 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AZ 1125188) |
| Enumeration Date | 2017-05-01 |
| Last Update Date | 2017-05-01 |