| NPI | 1053742304 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE PATRICE ROBINSON Office Administrator 267-272-9010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 385H00000X Respite Care | |
| Enumeration Date | 2013-12-11 |
| Last Update Date | 2013-12-15 |