| NPI | 1720833908 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANENE M. GORSETT Owner 712-212-4963 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2024-04-20 |
| Last Update Date | 2024-06-05 |