| NPI | 1831891316 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYAN DEAN SCOTT Managing Member 385-777-9766 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-03-20 |
| Last Update Date | 2024-04-12 |