| NPI | 1174111603 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMBER M FOSTER Owner 469-772-0904 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2021-01-10 |
| Last Update Date | 2024-09-12 |