| NPI | 1225582562 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNA AMANDA JEFFERSON CEO 800-647-3345 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 103TC1900X Psychologist, Counseling | |
| Enumeration Date | 2016-08-03 |
| Last Update Date | 2021-02-10 |