| NPI | 1043453798 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN CANTY Owner 980-230-3072 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2009-04-10 |
| Last Update Date | 2011-06-14 |