| NPI | 1013753698 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATIE STANFORD Psychiatric/Mental Health Np 740-200-0562 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2024-07-03 |
| Last Update Date | 2024-10-04 |