| NPI | 1235614678 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLETA C. WYLIE Owner 980-999-3547 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 251B00000X Case Management | |
| 251S00000X | |
| 253Z00000X In Home Supportive Care | |
| Enumeration Date | 2018-10-02 |
| Last Update Date | 2018-10-02 |