| NPI | 1386423812 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON L PEARCE CEO 762-328-9785 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical |
| Enumeration Date | 2023-09-25 |
| Last Update Date | 2024-02-22 |