NPI | 1194222174 |
---|---|
Entity Type | Organization |
Authorized Contact | DECORA BOWERS Owner 980-318-3125 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
Enumeration Date | 2018-04-06 |
Last Update Date | 2018-04-06 |