| NPI | 1023701158 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE MARKQUART Executive Director 800-989-3068 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2023-06-02 |
| Last Update Date | 2023-06-02 |