| NPI | 1629711023 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD RAY STIFF CEO 386-383-2129 |
| Organization Subpart ? | No |
| Primary Taxonomy | 405300000X Prevention Professional |
| Additional Taxonomies | 174400000X Specialist |
| 175T00000X Peer Specialist | |
| Enumeration Date | 2022-04-14 |
| Last Update Date | 2023-08-17 |