| NPI | 1386379469 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY PESATURO Owner 857-301-8596 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2022-07-21 |
| Last Update Date | 2022-07-28 |