| NPI | 1942812441 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VERA NGEZEM Owner 877-707-7790 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-08-18 |
| Last Update Date | 2022-11-23 |