| NPI | 1437579620 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN BAYNES Executive Director 888-870-1775 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: IL 15018) |
| Additional Taxonomies | 104100000X Social Worker |
| 106H00000X Marriage & Family Therapist | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 101YM0800X Counselor, Mental Health | |
| 103TC0700X Psychologist, Clinical | |
| 251S00000X | |
| Enumeration Date | 2014-04-26 |
| Last Update Date | 2018-04-24 |