| NPI | 1033895198 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH MARSHALL Executive Director 877-829-5500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2023-06-23 |
| Last Update Date | 2023-06-23 |