| NPI | 1295580678 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE OLIVIA JENNINGS- GIRAU CEO 848-240-8249 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-04-19 |
| Last Update Date | 2024-05-08 |