| NPI | 1316205453 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY DUBYK Associate Executive Director 267-893-5284 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2012-04-26 |
| Last Update Date | 2012-04-26 |