| NPI | 1174203137 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADAM KURTZ Counselor 980-288-2974 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-07-24 |
| Last Update Date | 2025-07-24 |