| NPI | 1255574752 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM LEE BOYD Licensed Professional Counselor 791-651-5605 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: CO 3369) |
| Enumeration Date | 2009-04-14 |
| Last Update Date | 2009-04-14 |