| NPI | 1558954818 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDI LYNN STONE Owner 980-613-5304 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YP2500X Counselor, Professional | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2021-02-18 |
| Last Update Date | 2021-02-18 |