| NPI | 1093203523 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIAN AUDREY STIEGELER Owner 458-240-2893 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2018-04-30 |
| Last Update Date | 2023-02-25 |