| NPI | 1225963291 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD BONTON Director Of Operations 346-842-9092 |
| Organization Subpart ? | No |
| Primary Taxonomy | 104100000X Social Worker |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2026-06-12 |
| Last Update Date | 2026-06-12 |