NPI | 1750881066 |
---|---|
Entity Type | Organization |
Authorized Contact | VIRGINIA E T BENNETT Sole Proprietor 270-315-1443 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Enumeration Date | 2018-02-14 |
Last Update Date | 2018-02-14 |