| NPI | 1639758162 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSE LEE PRICE Owner/Administrator 539-234-9787 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) | |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2021-04-02 |
| Last Update Date | 2025-10-20 |