NPI | 1013713395 |
---|---|
Entity Type | Organization |
Authorized Contact | SHIRELLE W DICKERSON Chief Operation Officer 144-449-0409 |
Organization Subpart ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
Enumeration Date | 2025-02-19 |
Last Update Date | 2025-06-02 |