| NPI | 1730954611 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA K CROUSE Owner 531-389-9440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2023-11-20 |
| Last Update Date | 2023-11-20 |