| NPI | 1952120024 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICE GAINES Founder 866-323-7326 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 101YP2500X Counselor, Professional | |
| 1041C0700X Social Worker, Clinical | |
| 133NN1002X Nutritionist, Nutrition, Education | |
| 175T00000X Peer Specialist | |
| 207RA0000X Internal Medicine, Adolescent Medicine | |
| 251S00000X | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2024-10-07 |
| Last Update Date | 2024-10-08 |