| NPI | 1740040203 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY R MOSELEY Owner 726-842-0498 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-03-21 |
| Last Update Date | 2024-04-03 |