| NPI | 1619481470 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIN TOWER Owner 857-264-2417 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: MA 9741) |
| Enumeration Date | 2017-11-30 |
| Last Update Date | 2021-07-01 |