| NPI | 1124207337 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HARVEY JOEL GREEN President 6121-339-7904 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: MN 27598) |
| Enumeration Date | 2007-10-24 |
| Last Update Date | 2007-10-24 |