| NPI | 1932559598 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARRIE J TREMBLE Owner 269-598-2748 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health (Licence: AZ LPC-16041) |
| Enumeration Date | 2016-06-15 |
| Last Update Date | 2016-06-15 |