| NPI | 1093307266 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINA NICOLE HOBSON Authorized Official, Human Resource 844-473-6378 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| Enumeration Date | 2021-02-09 |
| Last Update Date | 2025-03-14 |