| NPI | 1700616869 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANITA S MENSO CEO 267-999-9155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-08-05 |
| Last Update Date | 2024-08-05 |