| NPI | 1720924921 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVE HEROLD CEO 267-893-5500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2026-04-28 |
| Last Update Date | 2026-08-25 |