| NPI | 1568253334 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTINA E BAILEY Licensed Clinical Social Worker 385-275-2733 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2025-05-13 |
| Last Update Date | 2025-12-31 |