| NPI | 1417202136 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSE L GRIFFIN Owner/Director 877-214-3668 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MD LC3005) |
| Enumeration Date | 2012-07-18 |
| Last Update Date | 2012-07-18 |