| NPI | 1417530056 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA ANN TESTER Executive Director 567-201-2048 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2021-05-02 |
| Last Update Date | 2021-05-02 |