Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Mental Health (Including Community Mental Health Center) |
261QM0801X | B4[14] | Community Mental Health Center |
| NPI # | 1942591490 |
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| Entity | Organization | ||||
| Organization subpart 1 | Not specified | ||||
| Enumeration date | 05/02/2011 | ||||
| Last updated | 05/02/2011 - About 15 years ago | ||||
| Identifiers |
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JOSHUA A TIMS
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