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 Clinic/Center, Mental Health (Including Community Mental Health Center) | |
Enumeration Date | 2017-11-09 |
Last Update Date | 2024-10-22 |