| NPI | 1124372479 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINA M. BEHM Program Director 888-913-1428 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101Y00000X Counselor |
| 106H00000X Marriage & Family Therapist | |
| 133V00000X Dietitian, Registered | |
| Enumeration Date | 2012-11-07 |
| Last Update Date | 2019-01-07 |