| NPI | 1063133163 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENNIS RYAN Managing Partner 855-762-3796 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2022-09-07 |
| Last Update Date | 2022-09-07 |