| NPI | 1548928971 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MISTY GIBSON Owner 253-201-2436 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 171400000X Health & Wellness Coach | |
| 101Y00000X Counselor | |
| 104100000X Social Worker | |
| 171M00000X Case Manager/Care Coordinator | |
| 221700000X Art Therapist | |
| 251S00000X Community/Behavioral Health | |
| 1041C0700X Social Worker, Clinical | |
| 175T00000X Peer Specialist | |
| 101YP2500X Counselor, Professional | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2021-12-02 |
| Last Update Date | 2026-01-22 |