| NPI | 1922657477 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IVY PELLERITO Licensed Professional Counselor 816-427-1828 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-09-07 |
| Last Update Date | 2021-06-16 |