| NPI | 1619516796 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLINE REED Member 740-804-1526 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2020-01-06 |
| Last Update Date | 2020-01-06 |