| NPI | 1871378380 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIKA DE LA CRUZ Clinical Mental Health Counselor 980-417-1387 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-08-31 |
| Last Update Date | 2024-03-04 |