| NPI | 1316424310 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER RUEMENAPP Therapist 339-545-1368 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: MA 111226) |
| Enumeration Date | 2018-07-23 |
| Last Update Date | 2018-07-23 |