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Individual
MRS. MATRESSE LANITE MCALLISTER
Active
Individual
MRS. MATRESSE LANITE MCALLISTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
NULL
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
NULL
310500000X
Mental Illness Intermediate Care Facility
—
NULL
311ZA0620X
Adult Care Home Facility
Primary
—
NULL
315P00000X
Intellectual Disabilities Intermediate Care Facility
—
NULL
320800000X
Mental Illness Community Based Residential Treatment Facility
—
NULL
Other
Enumeration date
08/29/2011
Last updated
09/22/2011
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