| NPI | 1225896111 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBIN LEA KENNING Owner/ Np 469-990-3826 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-03-06 |
| Last Update Date | 2024-03-06 |