| NPI | 1073285136 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIRGINIA H YOUNG Clinical Director 334-610-0169 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2021-09-28 |
| Last Update Date | 2022-09-16 |