| NPI | 1184040321 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | PAUL KEVIN SOHR CEO 754-227-8937 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH11818) | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL 5753) | 
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2014-03-12 | 
| Last Update Date | 2014-03-12 |