| NPI | 1336897628 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIANA OWENS Owner 999-999-9999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 101YP2500X Counselor, Professional | |
| 1041C0700X Social Worker, Clinical | |
| 106H00000X Marriage & Family Therapist | |
| 106S00000X Behavior Technician | |
| 163W00000X Registered Nurse | |
| 164W00000X Licensed Practical Nurse | |
| 171M00000X Case Manager/Care Coordinator | |
| 175T00000X Peer Specialist | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| 405300000X Prevention Professional | |
| Enumeration Date | 2022-03-15 |
| Last Update Date | 2025-05-01 |