| NPI | 1003516626 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTORIA PENDER President/Provider 667-228-1735 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-03-03 |
| Last Update Date | 2024-08-29 |