| NPI | 1154102788 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALYSSIA BINION Owner 260-582-1835 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Additional Taxonomies | 172V00000X Community Health Worker |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2023-10-10 |
| Last Update Date | 2024-07-31 |