| NPI | 1619393816 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHEILA SHILATI CEO 866-244-8269 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 261QM0801X |
| Enumeration Date | 2014-03-12 |
| Last Update Date | 2015-06-11 |