| NPI | 1619759610 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYLA HARVEY Owner 980-259-1221 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-10-16 |
| Last Update Date | 2023-10-16 |