| NPI | 1063628170 |
|---|---|
| Doing Business As | SOUTHSIDE TREATMENT CENTER |
| Entity Type | Organization |
| Authorized Contact | SCOTT CALL VP, Managed Care 480-826-3929 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: VA 362-06-002) |
| 3336C0002X Pharmacy, Clinic Pharmacy (Licence: VA 00201003977) | |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2025-10-23 |