| NPI | 1780442533 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA MARTILIK Owner 469-364-9905 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-03-07 |
| Last Update Date | 2024-04-09 |