| NPI | 1841582996 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HERBERT DONALD DOCKERY Owner 251-599-7339 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AL LPC) |
| Enumeration Date | 2011-05-09 |
| Last Update Date | 2011-05-09 |