| NPI | 1598516940 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA ANDERSON President 855-380-6136 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 101YP2500X Counselor, Professional | |
| 103K00000X Behavior Analyst | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QP2300X Clinic/Center, Primary Care | |
| Enumeration Date | 2024-04-01 |
| Last Update Date | 2024-08-06 |