| NPI | 1154042380 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMY ANDERSON Owner 440-317-3779 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2022-09-06 |
| Last Update Date | 2022-09-06 |