| NPI | 1487114245 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH HARRIS Owner 479-274-0403 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YP2500X Counselor, Professional | |
| Enumeration Date | 2019-03-20 |
| Last Update Date | 2019-06-21 |