| NPI | 1639630619 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | LATOYA ST. PIERRE Owner 877-794-8661 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health | 
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health | 
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2019-03-30 | 
| Last Update Date | 2023-12-13 |