NPI | 1033001953 |
---|---|
Entity Type | Organization |
Authorized Contact | ROBERT WORTH Administrative Assistant 888-277-4028 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
Enumeration Date | 2025-07-16 |
Last Update Date | 2025-07-16 |