| NPI | 1134969082 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYL BOYLE Director, Rev Cycle Management 737-600-6039 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2024-05-29 |
| Last Update Date | 2024-09-03 |