| NPI | 1982309738 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROYLETA S FOSTER President 862-253-6722 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center Developmental Disabilities |
| Additional Taxonomies | 251B00000X Case Management |
| 251E00000X Home Health | |
| 251S00000X Community/Behavioral Health | |
| 251X00000X Supports Brokerage | |
| 253Z00000X In Home Supportive Care | |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| 261QM0850X Clinic/Center Adult Mental Health | |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| 385H00000X Respite Care | |
| 385HR2060X Respite Care Respite Care, Mental Retardation and/or Developmental Disabilities | |
| Enumeration Date | 2023-04-03 |
| Last Update Date | 2024-11-18 |