| NPI | 1821628017 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ECCLESIA HOLMES Owner 678-481-9702 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YP2500X Counselor, Professional | |
| Enumeration Date | 2020-01-16 |
| Last Update Date | 2020-01-16 |