| NPI | 1386214351 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAUREN NEAL Owner/Lpc 267-290-7911 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2021-06-30 |
| Last Update Date | 2021-07-01 |