| NPI | 1881463586 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NESHELLE RICHARDS Owner 531-999-1716 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Enumeration Date | 2023-12-22 |
| Last Update Date | 2023-12-22 |