| NPI | 1730766981 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEANDRA SALLEY Director 743-261-2480 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2021-03-25 |
| Last Update Date | 2026-06-22 |