| NPI | 1649911140 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLIE LEDBETTER Owner 334-478-0533 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| 261Q00000X Clinic/Center | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2022-04-06 |
| Last Update Date | 2022-04-06 |