| NPI | 1134902596 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIK GRAY Lcsw 808-446-9723 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-08-17 |
| Last Update Date | 2023-08-17 |