| NPI | 1609360031 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OOSHIE OLDHAM Owner 866-342-8847 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| Enumeration Date | 2018-06-19 |
| Last Update Date | 2018-06-19 |