| NPI | 1104673342 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OWEN ESLINGER CFO 571-888-5140 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2024-05-06 |
| Last Update Date | 2024-06-11 |