| NPI | 1427323336 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSE L GRIFFIN Director 877-214-3668 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MD LC3005) |
| Enumeration Date | 2012-03-12 |
| Last Update Date | 2012-03-12 |