| NPI | 1336766393 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER HALLEY Owner 469-400-8357 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 103T00000X Psychologist | |
| 171M00000X Case Manager/Care Coordinator | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health | |
| 363LP2300X Nurse Practitioner Primary Care | |
| Enumeration Date | 2020-06-25 |
| Last Update Date | 2020-06-25 |