| NPI | 1821229931 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERTA LEE CFO 800-477-7633 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NM 0122811) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NM 0122801) |
| Enumeration Date | 2009-08-06 |
| Last Update Date | 2009-08-06 |