| NPI | 1194556274 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA GILMER Manager 442-414-3090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 104100000X Social Worker |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2024-08-12 |
| Last Update Date | 2024-08-12 |