| NPI | 1538777610 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ABBEY WESTPHAL Registered Agent 906-367-1943 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-07-15 |
| Last Update Date | 2021-06-12 |