| NPI | 1578272951 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DREW C FULLER Owner 844-387-7469 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2022-11-15 |
| Last Update Date | 2025-10-21 |