| NPI | 1558184325 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELBY COOK MITCHELL Owneer 276-206-3040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 261QD1600X Clinic/Center, Developmental Disabilities | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 261QR1300X Clinic/Center, Rural Health | |
| Enumeration Date | 2024-11-01 |
| Last Update Date | 2024-11-01 |