| NPI | 1598278749 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTINS A ADEOYE CEO 331-330-9955 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry |
| 261QM0801X | |
| Enumeration Date | 2017-11-09 |
| Last Update Date | 2020-05-01 |