| NPI | 1851894620 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY FAITH TEMPLE CEO/Owner 567-343-2661 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 251B00000X Case Management |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2018-03-17 |
| Last Update Date | 2018-03-17 |