| NPI | 1144987389 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN RUSCITTO Owner 712-213-2205 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2021-11-23 |
| Last Update Date | 2022-01-14 |