| NPI | 1710774138 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRIS GALLINA Chief Compliance Officer 888-385-2051 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2025-04-21 |
| Last Update Date | 2025-04-21 |