| NPI | 1295570851 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENIKE MITCHELL DAVIS Owner/Clinician 522-412-4802 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-06-26 |
| Last Update Date | 2025-01-17 |