| NPI | 1710590575 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CEDRIC ITA EYO CEO/ Lead Clinician 346-375-7281 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2020-08-31 |
| Last Update Date | 2022-05-26 |