NPI | 1710113162 |
---|---|
Entity Type | Organization |
Authorized Contact | JASON T RALPH COO 800-434-4686 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
225100000X Physical Therapist | |
225X00000X Occupational Therapist | |
235Z00000X Speech-Language Pathologist, | |
Enumeration Date | 2009-05-29 |
Last Update Date | 2018-11-29 |