| NPI | 1760982391 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIA OH PARK Owner 205-643-0589 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: AL L444) |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: CA L444) |
| Enumeration Date | 2018-02-20 |
| Last Update Date | 2018-02-20 |