| NPI | 1710443627 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLIVIA POTTER Admissions Specialist 346-208-3296 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2019-02-15 |
| Last Update Date | 2024-06-07 |