| NPI | 1720778277 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TALIA KAELIN SAN ROMAN Owner 833-695-4673 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-05-09 |
| Last Update Date | 2023-05-09 |