| NPI | 1194556431 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KERRIE KING Co Owner 385-281-7680 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2024-08-09 |
| Last Update Date | 2025-08-01 |