| NPI | 1669184412 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOEL ALBERT Manager 725-301-1182 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| 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 | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2022-12-22 |
| Last Update Date | 2025-02-16 |