| NPI | 1982309738 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROYLETA FOSTER CEO 862-253-6818 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Additional Taxonomies | 261QM0801X |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2023-04-03 |
| Last Update Date | 2023-04-03 |