| NPI | 1437665478 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADRIENNE ANDEEN Owner 458-202-9366 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: OR L7509) |
| Enumeration Date | 2017-12-27 |
| Last Update Date | 2017-12-27 |