| NPI | 1104381052 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM CARTER WINOKUR President 389-689-8776 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2019-02-05 |
| Last Update Date | 2020-12-31 |