| NPI | 1144054586 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLARENCE TAYLOR CEO 385-232-9543 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2024-08-28 |
| Last Update Date | 2024-08-28 |