| NPI | 1881079069 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL JOSEPH PETERSON CEO/Director 385-333-6555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: UT 5388245-3501) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 101YM0800X Counselor Mental Health | |
| 1041C0700X Social Worker Clinical | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2015-07-29 |
| Last Update Date | 2024-09-23 |