| NPI | 1336818111 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHAN JUDD Owner 731-988-6589 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 101YP2500X Counselor, Professional | |
| Enumeration Date | 2021-09-07 |
| Last Update Date | 2021-09-07 |