| NPI | 1174268700 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY D KILPATRICK President 555-555-5555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-04-28 |
| Last Update Date | 2023-05-17 |