NPI | 1659928331 |
---|---|
Entity Type | Organization |
Authorized Contact | JENNIFER LYNN RATLIFF Owner 712-355-1526 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X |
Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
261QM0850X Clinic/Center, Adult Mental Health | |
261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
Enumeration Date | 2019-08-19 |
Last Update Date | 2019-08-19 |