| NPI | 1255015210 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WESAM SHASH Owner 256-850-4091 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2023-06-12 |
| Last Update Date | 2023-06-12 |