| NPI | 1891447082 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSE VICK CFO 888-228-2384 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| Enumeration Date | 2022-01-19 |
| Last Update Date | 2022-05-18 |