| NPI | 1548949027 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATHERINE BOELLNER Owner 567-343-0890 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-07-12 |
| Last Update Date | 2024-04-02 |