NPI | 1588317903 |
---|---|
Entity Type | Organization |
Authorized Contact | BRANDON TIMOTHY ANTOSKOW Owner 615-573-3837 |
Organization Subpart ? | No |
Primary Taxonomy | 101YM0800X Counselor Mental Health |
Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
Enumeration Date | 2022-01-27 |
Last Update Date | 2025-05-15 |