| NPI | 1629822184 |
|---|---|
| Former Legal Business Name | BLACK FALLS THERAPY AND WELLNESS, LLC |
| Entity Type | Organization |
| Authorized Contact | KRISTINA M ODUMES Clinic Director 609-491-2924 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2024-04-12 |
| Last Update Date | 2024-04-12 |