| NPI | 1760075212 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER ROMAN-MARTIN Owner 857-242-1098 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-02-16 |
| Last Update Date | 2021-02-16 |