| NPI | 1477164911 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIA DOWNER COO 844-942-1789 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251K00000X Public Health or Welfare |
| Additional Taxonomies | 103T00000X Psychologist |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 261QR0800X Clinic/Center, Recovery Care | |
| Enumeration Date | 2020-08-10 |
| Last Update Date | 2020-09-03 |