| NPI | 1508593377 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EVAN MOORE Founder/Owner 833-749-3549 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 101YM0800X Counselor Mental Health | |
| 101YP2500X Counselor Professional | |
| 261Q00000X Clinic/Center | |
| Enumeration Date | 2022-08-02 |
| Last Update Date | 2025-01-14 |