| NPI | 1871091066 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIARA MOORE Owner 302-464-6075 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: DE 0000829) |
| Enumeration Date | 2018-01-23 |
| Last Update Date | 2021-07-14 |