| NPI | 1447877766 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH ELIAS Owner 862-500-4997 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 104100000X Social Worker |
| Enumeration Date | 2020-07-02 |
| Last Update Date | 2025-01-08 |