| NPI | 1992436653 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELLEN LABGOLD Provider 571-233-2302 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-06-22 |
| Last Update Date | 2022-06-22 |