| NPI | 1407693559 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CIERRA JACKSON CEO 937-502-5037 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YP2500X Counselor Professional |
| Enumeration Date | 2024-07-15 |
| Last Update Date | 2024-08-07 |