| NPI | 1518716570 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE GILLIAM VP Of Operations 833-494-6724 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| Additional Taxonomies | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| 261QM0850X Clinic/Center Adult Mental Health | |
| Enumeration Date | 2024-05-14 |
| Last Update Date | 2025-04-21 |