| NPI | 1902499924 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAULETTE CHOBOT Owner 267-278-4063 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-02-19 |
| Last Update Date | 2021-02-19 |