| NPI | 1295365922 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLLEEN MCMAHON Owner 228-463-2680 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2020-01-22 |
| Last Update Date | 2020-01-22 |