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 |