| NPI | 1417772971 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD THATCHER Chief Financial Officer 754-217-8127 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2024-11-20 |
| Last Update Date | 2024-11-20 |