| NPI | 1538674932 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATASSIA NICHOLE WEATHERLY Owner 870-313-9072 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: AR P1202024) |
| Enumeration Date | 2017-12-06 |
| Last Update Date | 2017-12-06 |