| NPI | 1972029155 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN KEITH SHAFFER Owner 866-840-5286 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 251S00000X Community/Behavioral Health | |
| 101YP1600X Counselor, Pastoral | |
| 101YP2500X Counselor, Professional | |
| Enumeration Date | 2017-08-18 |
| Last Update Date | 2025-09-06 |