| NPI | 1033076302 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YEVGENIY TILMAN Executive Director 800-913-2615 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2026-01-07 |
| Last Update Date | 2026-01-07 |