| NPI | 1205463254 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANTELL BURNS Owner 225-402-2299 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-03-26 |
| Last Update Date | 2024-01-09 |