NPI | 1578125969 |
---|---|
Entity Type | Organization |
Authorized Contact | ANDREA KELLEY-FREEMAN CEO 800-867-2395 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Additional Taxonomies | 251S00000X |
261QC1500X Clinic/Center, Community Health | |
261QM1300X Clinic/Center, Multi-Specialty | |
Enumeration Date | 2019-07-05 |
Last Update Date | 2019-07-05 |