| NPI | 1679024301 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLORIA OVERSMITH Accounts Receivable And Billing Man 667-600-2249 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health |
| Enumeration Date | 2016-10-18 |
| Last Update Date | 2016-10-18 |