| NPI | 1720562754 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TASHAUNA WILCOX COO 877-306-4600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 251B00000X Case Management |
| 251S00000X | |
| Enumeration Date | 2018-09-15 |
| Last Update Date | 2022-03-25 |