| NPI | 1659524395 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL W SLACK VP For Marketing And Business Devel 800-854-3123 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: PA 201990) |
| Additional Taxonomies | 251S00000X (Licence: PA 201990) |
| Enumeration Date | 2008-10-28 |
| Last Update Date | 2022-07-21 |