| NPI | 1992494496 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALYSON R. KUROSKI-MAZZEI CEO / Cmo 980-859-2106 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| Enumeration Date | 2023-05-02 |
| Last Update Date | 2024-04-05 |