| NPI | 1669690335 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HILDA RODRIGUEZ Administrative Analyst 442-265-1546 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2022-02-04 |