| NPI | 1427707314 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILLIP BLEDSOE CEO 725-577-8636 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health |
| Additional Taxonomies | 261QM2500X Clinic/Center Medical Specialty |
| Enumeration Date | 2022-03-20 |
| Last Update Date | 2022-12-18 |