| NPI | 1184263113 |
|---|---|
| Former Legal Business Name | GOAL SUCCEEDERS |
| Entity Type | Organization |
| Authorized Contact | CHAZ LAMAR CLYBURN Certified Peer Counselor 757-800-7806 |
| Organization Subpart ? | No |
| Primary Taxonomy | 372600000X Adult Companion |
| Enumeration Date | 2019-12-20 |
| Last Update Date | 2019-12-20 |