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, Psych/Mental Health | |
Enumeration Date | 2022-11-04 |
Last Update Date | 2023-08-07 |