| NPI | 1659122703 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTIN MILLER Owner 786-610-8632 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) |
| Enumeration Date | 2024-03-28 |
| Last Update Date | 2024-03-28 |