| NPI | 1447569264 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA ELLIOTT SHANNON CEO 877-957-3422 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: FL MH11189) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: FL SW7468) |
| 102L00000X Psychoanalyst (Licence: FL SW7468) | |
| 1041C0700X Social Worker, Clinical (Licence: FL SW7468) | |
| 101Y00000X Counselor (Licence: FL MH11189) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL 5525) | |
| 101YM0800X Counselor, Mental Health (Licence: FL MH11189) | |
| 102L00000X Psychoanalyst (Licence: FL MH11189) | |
| 103K00000X Behavior Analyst (Licence: FL SW7468) | |
| 104100000X Social Worker (Licence: FL SW7468) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL 5552) | |
| Enumeration Date | 2010-09-28 |
| Last Update Date | 2014-03-19 |