| NPI | 1053237859 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAREACA BOSTICK Founder 478-973-8627 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 133V00000X Dietitian, Registered |
| Enumeration Date | 2026-06-25 |
| Last Update Date | 2026-07-15 |