| NPI | 1407516370 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA EDWARDS Clinical Director 888-692-6590 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-12-20 |
| Last Update Date | 2025-04-04 |