| NPI | 1952171605 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERESE IZZARD Director 267-777-1206 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101Y00000X Counselor |
| 103K00000X Behavior Analyst | |
| 171M00000X Case Manager/Care Coordinator | |
| 251B00000X Case Management | |
| 251E00000X Home Health | |
| 252Y00000X Early Intervention Provider Agency | |
| 253Z00000X In Home Supportive Care | |
| Enumeration Date | 2024-01-04 |
| Last Update Date | 2024-01-04 |