| NPI | 1639926959 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH ROURKE Owner 339-203-9897 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-05-03 |
| Last Update Date | 2024-05-03 |