| NPI | 1811696768 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXANDRIA VICTORIA WILLIAMS Owner 346-588-3832 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2023-02-28 |
| Last Update Date | 2023-02-28 |