| NPI | 1013450659 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS RIVERA COO 862-596-0850 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2016-11-30 |
| Last Update Date | 2016-11-30 |