| NPI | 1427748276 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CERISSA CARROLL PAYMENT RHODES Owener 808-375-0074 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-05-15 |
| Last Update Date | 2023-08-28 |