| NPI | 1225577513 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHAN ISAIAH HUDSON Owner 561-847-5688 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2017-02-20 |
| Last Update Date | 2023-11-24 |