| NPI | 1659760411 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY JACKSON NEUFELD President 855-200-2471 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: UT 10870) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: UT 10870) |
| Enumeration Date | 2015-01-16 |
| Last Update Date | 2016-11-04 |