NPI | 1326745704 |
---|---|
Entity Type | Organization |
Authorized Contact | JAY M RATIA Owner 984-999-1213 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X Community/Behavioral Health |
Additional Taxonomies | 261QM0801X |
261QM0850X Clinic/Center, Adult Mental Health | |
261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
Enumeration Date | 2023-02-15 |
Last Update Date | 2023-02-15 |