| NPI | 1710714167 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL B JENSEN Owner/Founder 385-275-5737 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2024-09-18 |
| Last Update Date | 2024-09-18 |