| NPI | 1962161554 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARONDA ROBERTS Executive Director 197-386-1510 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Enumeration Date | 2021-12-11 |
| Last Update Date | 2021-12-11 |