| NPI | 1518716414 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BOULOS SAAD Sole Member 615-243-0968 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2024-05-14 |
| Last Update Date | 2024-09-17 |