| NPI | 1124819149 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LIZA N HEYWARD Owner 862-668-0816 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2025-05-16 |
| Last Update Date | 2025-05-16 |