| NPI | 1922412089 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA MARES Owner 740-703-5048 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2014-06-17 |
| Last Update Date | 2025-06-19 |