| NPI | 1649759853 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ILYANI LENA ABOUREZK Owner 605-863-2881 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: SD LPC-MH2276) |
| Enumeration Date | 2018-08-08 |
| Last Update Date | 2019-01-17 |