| NPI | 1427838580 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMIAH GARRETT DALTON Owner 334-796-1485 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-10-04 |
| Last Update Date | 2023-10-04 |