| NPI | 1104373018 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRAIG MCCULLOUGH President 182-877-5151 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CO 3661) |
| Enumeration Date | 2016-09-08 |
| Last Update Date | 2016-11-07 |