| NPI | 1194230789 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE WALKER Business Manager 769-777-1046 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2017-12-05 |
| Last Update Date | 2019-01-11 |