| NPI | 1073328704 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMIE BROWN Business Manager 833-575-4012 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2025-02-10 |
| Last Update Date | 2026-07-10 |