| NPI | 1306602354 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA P RICHARDSON Owner 276-790-9797 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YS0200X Counselor, School | |
| 103T00000X Psychologist | |
| 1041C0700X Social Worker, Clinical | |
| 251B00000X Case Management | |
| 251S00000X | |
| 261QP0904X Clinic/Center, Public Health, Federal | |
| Enumeration Date | 2024-02-27 |
| Last Update Date | 2024-02-27 |