| NPI | 1003547837 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRAVIS OWENS Owner 740-451-0342 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2022-06-22 |
| Last Update Date | 2024-03-26 |