| NPI | 1669197612 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATASHA L MONTGOMERY Owner 682-292-8306 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2022-10-11 |
| Last Update Date | 2022-10-11 |