| NPI | 1497339634 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWINNA WYNN CEO 888-763-7272 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2021-05-12 |
| Last Update Date | 2021-12-06 |