| NPI | 1578857967 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TANYA MAULDIN Exec VP 866-525-5484 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2011-06-03 |
| Last Update Date | 2022-05-12 |