NPI | 1053983148 |
---|---|
Entity Type | Organization |
Authorized Contact | BRITTANY R PRATT Administrator 740-249-4514 |
Organization Subpart ? | No |
Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
103TA0400X Psychologist, Addiction (Substance Use Disorder) | |
Enumeration Date | 2021-07-16 |
Last Update Date | 2025-05-09 |