NPI | 1467339325 |
---|---|
Entity Type | Organization |
Authorized Contact | HEATHER IBACH Owner 701-204-3308 |
Organization Subpart ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
Enumeration Date | 2025-08-20 |
Last Update Date | 2025-08-20 |