| NPI | 1245983659 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA TAKACS Clinical Social Worker 564-210-7035 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health |
| Enumeration Date | 2022-01-27 |
| Last Update Date | 2022-01-27 |