| NPI | 1053934836 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN A SANDERS Medical Doctor 866-678-8123 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2020-05-27 |
| Last Update Date | 2023-08-16 |