| NPI | 1659505394 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NELSON G MONROY Member 888-695-9740 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2009-05-10 |
| Last Update Date | 2009-05-10 |