| NPI | 1295431260 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHONTAE ALEXIS COX Business Owner And Provider 681-439-1747 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-02-01 |
| Last Update Date | 2023-02-07 |