| NPI | 1154098721 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICKI SOULE CEO 772-257-8224 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2021-08-23 |
| Last Update Date | 2022-03-22 |