| NPI | 1649160656 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SYDNEY JASPER Owner 910-275-4862 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2025-07-09 |
| Last Update Date | 2026-08-29 |