| NPI | 1861956740 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARA GARRETT Member Manager 251-689-2477 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-01-25 |
| Last Update Date | 2019-01-25 |