| NPI | 1942968649 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI KOLIN Authorized Person 877-959-8180 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-11-30 |
| Last Update Date | 2024-08-16 |