| NPI | 1447930920 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LELAND NEWMAN Owner 551-579-3656 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YP2500X Counselor Professional |
| 1041C0700X Social Worker Clinical | |
| Enumeration Date | 2023-07-20 |
| Last Update Date | 2024-06-21 |