| NPI | 1972140424 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMILY S PATTERSON Owner 251-680-0734 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| Enumeration Date | 2019-12-03 |
| Last Update Date | 2019-12-03 |