| NPI | 1982179487 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDI STONE Co Owner 980-613-5304 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 251B00000X Case Management |
| 251C00000X Day Training, Developmentally Disabled 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 | |
| 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| Enumeration Date | 2018-10-11 |
| Last Update Date | 2018-11-19 |