| NPI | 1841049855 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA JANE ADKINSON Office Manager 270-898-4044 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry |
| Additional Taxonomies | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-05-14 |
| Last Update Date | 2024-11-12 |