| NPI | 1578349783 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSALINDA A LOGAN-PETERS Revenue Manager 731-935-9267 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 251B00000X Case Management | |
| Enumeration Date | 2023-09-04 |
| Last Update Date | 2023-09-04 |