| NPI | 1992470561 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHERINE ROSE CHENGAPPA Director Of Administration 385-337-4391 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2021-08-15 |
| Last Update Date | 2021-08-17 |