| 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 |