| NPI | 1124739644 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLOS PROCTOR CEO 980-294-0965 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2022-12-06 |
| Last Update Date | 2022-12-06 |