| NPI | 1134850548 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTORIA EVANS-FULTON Licensed Proffessional Counselor 276-477-4174 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-06-17 |
| Last Update Date | 2024-02-05 |