| NPI | 1326850074 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TABREA SLEDGE Clinical Director 984-218-4675 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2025-01-21 |
| Last Update Date | 2025-08-27 |