| NPI | 1548356462 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE MARNELL Director 800541-440-1000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2008-08-18 |