| NPI | 1689330672 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY CHAMBERS Owner 754-900-8280 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-11-13 |
| Last Update Date | 2021-11-13 |