| NPI | 1396480638 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY SHANE COUCH President/Co Founder 408-890-6306 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP1600X Counselor Pastoral |
| Additional Taxonomies | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-05-02 |
| Last Update Date | 2022-05-02 |