| NPI | 1871341206 |
|---|---|
| Former Legal Business Name | NONE |
| Entity Type | Organization |
| Authorized Contact | JOSEPH DAVID CHAMBERS Owner 346-579-8574 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2024-05-09 |
| Last Update Date | 2024-07-21 |