| NPI | 1578023685 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KASSANDRA DECKER Owner Lpc 662-640-2069 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-03-24 |
| Last Update Date | 2022-02-09 |