| NPI | 1942447891 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HILLERIE B. MADDOX Licensed Professional Counselor 267-978-7939 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2009-01-14 |
| Last Update Date | 2009-01-14 |