| NPI | 1568274835 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LACIE MARTINEZ Owner/ CEO 270-799-1415 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2025-01-23 |
| Last Update Date | 2025-01-23 |