| NPI | 1659161339 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUCAS HESTER Owner 251-572-1050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2025-05-07 |
| Last Update Date | 2025-05-07 |