| NPI | 1003641606 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OSAZE BATHOLOMEW IBHAWA Mental Health Counselor 716-322-9088 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 251B00000X Case Management | |
| Enumeration Date | 2024-09-04 |
| Last Update Date | 2024-11-20 |