| NPI | 1972309466 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY ZARAGOZA CEO 183-221-6429 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center Rehabilitation |
| Additional Taxonomies | 261QM0850X Clinic/Center Adult Mental Health |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2025-02-24 |
| Last Update Date | 2025-02-24 |