| NPI | 1407390610 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHRYN ANN NEY Owner 251-626-1182 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: AL 24015) |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: AL 24015) |
| Enumeration Date | 2016-12-06 |
| Last Update Date | 2016-12-06 |