NPI | 1578170882 |
---|---|
Entity Type | Organization |
Authorized Contact | CHARMAINE FORTS Owner 678-834-5711 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2020-09-30 |
Last Update Date | 2023-06-17 |