| NPI | 1669944856 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOY TANNER Owner/Manager 984-235-2545 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2018-12-28 |
| Last Update Date | 2018-12-28 |