| NPI | 1538544424 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHALEEN J GASTON Owner 980-213-8589 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 302R00000X Health Maintenance Organization |
| Enumeration Date | 2015-07-21 |
| Last Update Date | 2015-07-21 |