| NPI | 1407620453 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RHEA LOU DEL ROSARIO CEO, Pmhnp 218-999-0018 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-11-09 |
| Last Update Date | 2024-02-02 |