| NPI | 1740032556 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIMAY L MAXWELL Owner/President 754-213-1619 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 261QA0600X Clinic/Center, Adult Day Care |
| Enumeration Date | 2024-04-04 |
| Last Update Date | 2024-04-04 |