| NPI | 1124819214 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHAD ALLEN LAZZARI Owner/Operator 802-440-0972 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2025-05-16 |
| Last Update Date | 2025-05-16 |