NPI | 1073300554 |
---|---|
Entity Type | Organization |
Authorized Contact | CAMERON WHITE Owner 765-617-6031 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
Enumeration Date | 2025-04-21 |
Last Update Date | 2025-04-21 |