| NPI | 1093255226 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA MARIE TAYLOR Clinical Director 385-626-9345 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: UT 320724-3501) |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2017-03-07 |
| Last Update Date | 2024-12-20 |