| NPI | 1659006740 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SIEDAH MARTIN Owner/Licensed Clinical Social Work 980-224-0239 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-07-21 |
| Last Update Date | 2022-07-21 |