| NPI | 1629890744 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYL BOYLE Director, Rcm 737-600-6039 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2024-10-29 |
| Last Update Date | 2024-12-05 |