| NPI | 1962094284 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANESHIA MONAY GUTIERREZ Owner 336-609-1336 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 251S00000X |
| 251B00000X Case Management | |
| 253Z00000X In Home Supportive Care | |
| 261Q00000X Clinic/Center | |
| 261QC1500X Clinic/Center, Community Health | |
| 251E00000X Home Health | |
| 261QH0100X Clinic/Center, Health Services | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2021-02-08 |
| Last Update Date | 2021-11-22 |