| NPI | 1699637736 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERICA WALTER Licensed Professional Counselor (Lp 870-707-1467 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| 261Q00000X Clinic/Center | |
| Enumeration Date | 2025-11-26 |
| Last Update Date | 2025-12-30 |