| NPI | 1063718419 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRED SURGEON CEO 1877-472-2302 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 104100000X Social Worker | |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2011-02-02 |
| Last Update Date | 2011-02-02 |