| NPI | 1548086515 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAURICE HINSON Owner 267-634-7011 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care |
| Additional Taxonomies | 261QM0850X Clinic/Center Adult Mental Health |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| Enumeration Date | 2024-11-25 |
| Last Update Date | 2024-11-25 |