| NPI | 1164938775 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN POEHLMAN Owner 667-231-4286 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: MD LC2933) |
| Enumeration Date | 2017-12-19 |
| Last Update Date | 2017-12-19 |