| NPI | 1295580280 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARINA VILE Owner 360-205-0757 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-04-22 |
| Last Update Date | 2024-04-22 |