| NPI | 1316836620 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | QUALESHIA SMITH Owner 331-444-2302 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| Enumeration Date | 2025-07-01 |
| Last Update Date | 2025-07-01 |