| NPI | 1972327294 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARITSA L YZAGUIRRE-KELLEY Owner 754-200-9971 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-11-13 |
| Last Update Date | 2025-09-18 |