| NPI | 1003671355 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY STRATTON Owner 386-965-6901 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2024-02-15 |
| Last Update Date | 2024-02-15 |