| NPI | 1750863668 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY G PENNANT CEO 267-997-8744 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2018-09-06 |
| Last Update Date | 2018-09-06 |