| NPI | 1871223222 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COSETTE RAE CEO 800-682-0670 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-06-16 |
| Last Update Date | 2022-06-16 |