| NPI | 1396529491 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEEGAN MAURER Owner 385-335-4917 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-08-21 |
| Last Update Date | 2023-08-21 |