| NPI | 1780379024 |
|---|---|
| Other Name | N/A |
| Entity Type | Organization |
| Authorized Contact | ALISSA JEANNE WALSH Owner 267-223-7044 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2023-04-11 |
| Last Update Date | 2024-02-29 |