| NPI | 1376134866 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMBERLY RENEE STANFILL Co Owner 725-204-7591 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101Y00000X Counselor |
| 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine | |
| 101YM0800X Counselor, Mental Health | |
| 104100000X Social Worker | |
| Enumeration Date | 2021-01-28 |
| Last Update Date | 2021-01-28 |