| NPI | 1295575561 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HANNAH WIDMER Owner 765-337-4671 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-05-25 |
| Last Update Date | 2024-05-25 |