| NPI | 1891557286 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TESSA SINGLETON Owner 385-236-1974 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-01-30 |
| Last Update Date | 2025-04-24 |