| NPI | 1063889137 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTIAN JOSE DEAN Co Owner 225-205-7508 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: LA 2772) |
| Enumeration Date | 2015-08-25 |
| Last Update Date | 2015-08-25 |