| NPI | 1154594950 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY JOHN SCALETTA CEO 800-614-4124 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2008-04-12 |
| Last Update Date | 2022-12-30 |