| NPI | 1962113399 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONOVAN L SHAVERS Executive Director/Founder 870-556-0335 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine |
| Additional Taxonomies | 251K00000X Public Health or Welfare |
| 251S00000X | |
| 261QC1500X Clinic/Center, Community Health | |
| 261QP0905X Clinic/Center, Public Health, State or Local | |
| 261QR1300X Clinic/Center, Rural Health | |
| 251B00000X Case Management | |
| Enumeration Date | 2022-12-06 |
| Last Update Date | 2022-12-06 |