| NPI | 1801422829 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | GEORGGETTA HOWIE Owner 571-265-6297 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health | 
| Additional Taxonomies | 103T00000X Psychologist | 
| 103TP2701X Psychologist, Group Psychotherapy | |
| 1041C0700X Social Worker, Clinical | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| Enumeration Date | 2020-03-21 | 
| Last Update Date | 2020-03-21 |