| NPI | 1639727936 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CORY D EASTGATE Co Founder 330-815-1551 |
| Organization Subpart ? | No |
| Primary Taxonomy | 175T00000X Peer Specialist |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| Enumeration Date | 2019-08-29 |
| Last Update Date | 2020-06-02 |