| NPI | 1104657907 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN AARON FIELDS President/CEO 551-206-1387 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-08-12 |
| Last Update Date | 2024-11-14 |