| NPI | 1114664604 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BECKY JO LLOYD HATFIELD Partner/ Operations And Office Mgr 154-123-9843 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Enumeration Date | 2022-05-16 |
| Last Update Date | 2022-05-16 |