| NPI | 1861002768 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTEN DIANE CHAMBERS Clinical Therapist 567-218-1207 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2020-08-05 |
| Last Update Date | 2024-04-29 |