| NPI | 1407783046 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC MALZ ERIC MALZ Owner/Provider 551-804-1618 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2026-05-07 |
| Last Update Date | 2026-05-07 |