| NPI | 1306409354 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA MOSSFORD-CARROLL CEO 386-316-3004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 251B00000X Case Management | |
| 251S00000X | |
| Enumeration Date | 2019-04-16 |
| Last Update Date | 2022-09-29 |