| NPI | 1003313537 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA KUHLEN Director 442-265-1525 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2018-04-11 |
| Last Update Date | 2018-04-11 |