| NPI | 1730884537 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA L SMITH Owner 260-239-7956 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2023-04-03 |
| Last Update Date | 2024-08-07 |