| NPI | 1073639159 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLORIA REEVES A/R And Billing Mgr 667-600-2249 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2020-01-02 |