| NPI | 1699234880 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATRICA HENEGAR Owner 334-275-9579 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-03-18 |
| Last Update Date | 2020-06-16 |