| NPI | 1679846505 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARON C JACKSON Owner 888-492-9386 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2012-02-23 |
| Last Update Date | 2021-05-20 |