| NPI | 1366007460 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAXIMO DE LA CRUZ Chief Director 571-572-0050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2019-05-03 |
| Last Update Date | 2022-06-16 |