| NPI | 1790397230 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADAM NORMAN THARKUR Owner 904-547-0480 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2020-08-17 |
| Last Update Date | 2023-04-13 |