| NPI | 1255171260 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN CLAYPOOL Owner 567-204-6973 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 1041C0700X Social Worker Clinical |
| 251B00000X Case Management | |
| 251S00000X Community/Behavioral Health | |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| 261QM2500X Clinic/Center Medical Specialty | |
| 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2024-05-28 |
| Last Update Date | 2024-05-29 |