| NPI | 1174115539 |
|---|---|
| Doing Business As | LIFE POURED OUT SERVICES, INC. |
| Entity Type | Organization |
| Authorized Contact | SUZETT DELICIA BLOUNT Therapist/Co Founder 718-644-4998 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2021-02-08 |
| Last Update Date | 2021-12-08 |