| NPI | 1669898532 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FORTUNATE E OVBIAGELE Owner 334-356-5931 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health (Licence: AL 22241) |
| Enumeration Date | 2014-03-14 |
| Last Update Date | 2014-03-14 |