| NPI | 1194598755 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENDRA WALKER Owner 618-301-7699 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2023-11-03 |
| Last Update Date | 2023-11-07 |