| NPI | 1689198095 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONADAB SAMUEL FRANCO CEO 910-817-9181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical |
| Enumeration Date | 2017-07-27 |
| Last Update Date | 2022-05-17 |