| NPI | 1215437959 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISULA TASIOPOULOS Owner/Director 622-097-3958 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2018-02-20 |
| Last Update Date | 2022-01-26 |