| NPI | 1245676634 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENNIS COOK CEO 267-256-5205 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2013-05-13 |
| Last Update Date | 2013-05-13 |