| NPI | 1972266757 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IRINA ASHAMALLA CEO 888-906-8301 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-10-18 |
| Last Update Date | 2024-08-11 |