| NPI | 1720865058 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMIA MICHAELA TAZZIA GEDDIE Chief Executive Officer 980-292-1617 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2023-09-11 |
| Last Update Date | 2023-09-11 |