| NPI | 1972035665 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SABRINA MARIE ERICKSON Owner 857-234-3789 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MA 118415) |
| Enumeration Date | 2017-03-31 |
| Last Update Date | 2023-09-06 |