| NPI | 1912860685 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RORY HILEMAN Owner 385-483-4757 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2025-12-08 |
| Last Update Date | 2025-12-08 |