| NPI | 1881919488 |
|---|---|
| Other Name | CHILDHOOD TRAUMA TREATMENT PROGRAM |
| Entity Type | Organization |
| Authorized Contact | GENE S. CARROCCIA Clinical Director 800-216-1110 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| Enumeration Date | 2010-04-07 |
| Last Update Date | 2010-04-07 |