| NPI | 1851075683 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAYLA MEYER Clinical Care Director/ Co Founder 386-479-3204 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2023-06-12 |
| Last Update Date | 2023-08-07 |