| NPI | 1003696279 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH WILLIAM COOK President 667-234-2100 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2023-10-04 |
| Last Update Date | 2023-10-04 |