| NPI | 1629794524 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ARTRESIA FRYAR Owner 848-229-5237 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| Enumeration Date | 2022-10-13 |
| Last Update Date | 2022-10-13 |