| NPI | 1831653781 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARIMA SHAGAGA President 424-274-2963 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2019-01-24 |
| Last Update Date | 2020-07-02 |