| NPI | 1598145955 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY N LYONS CEO 3057-617-0987 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 101YP2500X Counselor, Professional | |
| Enumeration Date | 2015-06-01 |
| Last Update Date | 2015-06-01 |