| NPI | 1245075191 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELSEY ROY Chief Financial Officer 267-261-6511 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2024-07-01 |
| Last Update Date | 2024-07-01 |