| NPI | 1114895414 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRY LAYMAN Sr. VP Corporate Medical Director 866-434-3255 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2025-10-28 |
| Last Update Date | 2025-10-28 |