| NPI | 1629648704 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY ROLLINS Owner 606-401-1905 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-06-30 |
| Last Update Date | 2024-09-10 |