| NPI | 1831031129 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARIN GABRIELA LOPEZ REYNA Owner 615-800-0947 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2026-04-07 |
| Last Update Date | 2026-04-07 |