| NPI | 1801269352 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DESIREE LEA STONE Clinical Director 844-986-6946 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AL 2892) |
| Enumeration Date | 2015-11-05 |
| Last Update Date | 2015-11-05 |