| NPI | 1790597383 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSE THOMAS JUNG GLACKIN Therapist/Owner 712-346-8213 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health |
| Additional Taxonomies | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| Enumeration Date | 2025-01-22 |
| Last Update Date | 2025-01-30 |