| NPI | 1922717305 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTEN BOYD Licensed Clinical Social Worker 331-248-5128 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2022-11-15 |
| Last Update Date | 2022-11-15 |