| NPI | 1205428075 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILIP NDEGWA NDEGWA Owner 774-293-4354 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-02-03 |
| Last Update Date | 2021-02-03 |