| NPI | 1033826383 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BLAKE BAILEY Co Founder/CEO 772-353-1410 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 207QA0401X Family Medicine Addiction Medicine | |
| 2084P0800X Psychiatry & Neurology Psychiatry | |
| 261QM1300X Clinic/Center Multi-Specialty | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health | |
| Enumeration Date | 2022-11-04 |
| Last Update Date | 2023-08-07 |