| NPI | 1538995873 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RHONDA MORRISON Administrative Officer 531-220-2628 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health |
| Enumeration Date | 2024-09-12 |
| Last Update Date | 2024-09-12 |