| NPI | 1740141688 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONI ALLAYNE BOULWARE STACKHOUSE Owner/Operator 144-322-6549 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2025-11-20 |
| Last Update Date | 2025-11-20 |