| NPI | 1669259958 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASMINE CLINTON Owner 251-751-2225 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-09-11 |
| Last Update Date | 2023-10-05 |