| NPI | 1578878757 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA ANNE DUNNING President 888-516-5995 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| Additional Taxonomies | 261QD1600X Clinic/Center Developmental Disabilities |
| 261QM0850X Clinic/Center Adult Mental Health | |
| Enumeration Date | 2010-08-12 |
| Last Update Date | 2010-08-12 |