| NPI | 1922753144 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY COUTO VP Operations 888-879-9786 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-02-16 |
| Last Update Date | 2024-01-11 |