| NPI | 1487010377 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICKIA MILLER Manager, Founder 860-805-0245 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: CT 1121) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) | |
| Enumeration Date | 2016-01-07 |
| Last Update Date | 2022-09-27 |