| NPI | 1194293712 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIELLE RUSSO Owner 205-718-0538 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2018-11-13 |
| Last Update Date | 2020-02-22 |