| NPI | 1255182994 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ABISOLA ONASHILE Provider 360-200-1696 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-03-29 |
| Last Update Date | 2024-03-29 |