| NPI | 1386424372 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER R OXFORD Executive Director 385-208-1760 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 251S00000X |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2023-10-05 |
| Last Update Date | 2023-10-05 |