| NPI | 1629359872 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VINCENT MAHON Co Owner 712-259-5134 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2011-09-01 |
| Last Update Date | 2011-09-01 |