| NPI | 1518736883 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VALEEA SUTTON Owner 980-285-2993 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2023-12-27 |
| Last Update Date | 2023-12-27 |