| NPI | 1285140004 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN F KILPATRICK Director 251-753-3833 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2017-12-15 |
| Last Update Date | 2025-11-06 |