| NPI | 1588046312 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY ANN ANDREWS Owner 216-310-8471 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TX 70803) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: TX 70803) |
| Enumeration Date | 2015-06-29 |
| Last Update Date | 2015-09-25 |