| NPI | 1457936395 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE SHERRILL-CORRY Owner 980-202-1723 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2021-03-12 |
| Last Update Date | 2022-05-03 |