| NPI | 1568137636 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH LINFIELD WILSON Counselor 769-300-6129 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-08-11 |
| Last Update Date | 2021-08-11 |