| NPI | 1396632295 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARIAN AVILES President 523-630-2022 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2025-06-23 |
| Last Update Date | 2025-08-12 |