| NPI | 1144548066 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYLER SAMUAL SEEVER Chief Operating Officer 857-350-4400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 3185) |
| Enumeration Date | 2010-05-17 |
| Last Update Date | 2010-05-17 |