NPI | 1780481945 |
---|---|
Entity Type | Organization |
Authorized Contact | CLAYTON BLACK Owner 740-243-5542 |
Organization Subpart ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
Enumeration Date | 2025-02-26 |
Last Update Date | 2025-02-26 |