| NPI | 1831086438 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMANTHA GINGLES Owner 980-729-2772 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2025-06-18 |
| Last Update Date | 2025-06-18 |