| NPI | 1043852510 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JO ANNA JOHNSON Owner 251-591-2997 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-10-16 |
| Last Update Date | 2022-04-05 |