| NPI | 1770432866 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANITA BOWLING President 315-225-8171 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2026-01-22 |
| Last Update Date | 2026-08-13 |