| NPI | 1952256927 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENEAPHA RENEE PATTON Program Director 800-402-0941 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 175T00000X Peer Specialist |
| Enumeration Date | 2026-03-03 |
| Last Update Date | 2026-03-03 |