| NPI | 1477166197 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BREANNA BUTLER Owner 980-254-3947 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-08-24 |
| Last Update Date | 2024-04-19 |