| NPI | 1659232833 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULEI SONG Director 888-868-8410 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2025-11-18 |
| Last Update Date | 2026-03-13 |