| NPI | 1962266320 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENNIS CEDRIC HATFIELD Owner 336-609-1336 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Additional Taxonomies | 251B00000X Case Management |
| 251E00000X Home Health | |
| 251S00000X Community/Behavioral Health | |
| 253Z00000X In Home Supportive Care | |
| 261QC1500X Clinic/Center, Community Health | |
| 261QD1600X Clinic/Center, Developmental Disabilities | |
| 261QH0100X Clinic/Center, Health Services | |
| 261QM0801X | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2024-02-07 |
| Last Update Date | 2024-02-07 |