| NPI | 1821717638 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZIA SKEPPLE Managing Director 346-297-0733 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| 102L00000X Psychoanalyst | |
| 251S00000X Community/Behavioral Health | |
| 101Y00000X Counselor | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 101YM0800X Counselor, Mental Health | |
| 101YP2500X Counselor, Professional | |
| Enumeration Date | 2022-08-24 |
| Last Update Date | 2025-08-03 |