| NPI | 1124726625 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT GOMEZ Clinician/Owner 872-888-2156 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-02-23 |
| Last Update Date | 2023-02-23 |