| NPI | 1790961985 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD MOODY Chief Financial Officer 571-334-3144 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: AZ BH-3030) |
| Enumeration Date | 2008-01-17 |
| Last Update Date | 2024-08-16 |