| NPI | 1750239489 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TABITHA MARTIN Authorized Official 346-655-4033 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| 251S00000X Community/Behavioral Health | |
| 251B00000X Case Management | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2026-03-18 |
| Last Update Date | 2026-03-25 |