| NPI | 1992592240 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | QUINETTA WHITLEY Owner 469-215-9693 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 251B00000X Case Management |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2025-04-21 |
| Last Update Date | 2025-04-21 |