NPI | 1053002923 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
Enumeration Date | 2023-05-19 |
Last Update Date | 2023-12-18 |