| NPI | 1346860350 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM GOLPHIN Owner 267-474-8573 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2020-04-20 |
| Last Update Date | 2020-04-20 |