| NPI | 1912798661 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH ESSAS Managing Director 800-646-1202 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| 322D00000X Residential Treatment Facility, Emotionally Disturbed Children | |
| 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children | |
| Enumeration Date | 2025-05-13 |
| Last Update Date | 2025-05-13 |