| NPI | 1639926603 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA KELLY Owner/CEO 234-249-2189 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2024-05-06 |
| Last Update Date | 2024-10-15 |