| NPI | 1467028530 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLI MARIE LYLES Owner 253-224-0509 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-05-31 |
| Last Update Date | 2021-05-31 |