| NPI | 1770178816 |
|---|---|
| Doing Business As | 360 INNOVATIVE THERAPY |
| Entity Type | Organization |
| Authorized Contact | BEVERLY MCNAIRY CEO 571-575-3767 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor, Mental Health | |
| 101YS0200X Counselor, School | |
| Enumeration Date | 2021-03-01 |
| Last Update Date | 2021-03-01 |