| NPI | 1922507730 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON-ANTHONY KIRKHAM PRENDERGAST President & CEO 888-773-3439 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: FL 17769) |
| Enumeration Date | 2018-02-07 |
| Last Update Date | 2018-02-07 |