| NPI | 1154196277 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLEY KELCEE AGUEDA-DIVENS Owner 443-540-8280 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| Enumeration Date | 2023-11-20 |
| Last Update Date | 2024-04-25 |