| NPI | 1346816402 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXANDER JAMES GOREHAM Owner 331-903-0283 |
| Organization Subpart ? | No |
| Primary Taxonomy | 104100000X Social Worker |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 101YP2500X Counselor Professional | |
| Enumeration Date | 2021-05-31 |
| Last Update Date | 2022-03-23 |