| NPI | 1194240291 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SONNY ETIENNE Owner 754-281-0749 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2017-08-09 |
| Last Update Date | 2019-11-15 |