| NPI | 1073128690 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTOINETTE BOGAN Clinical Director 267-704-9187 |
| Organization Subpart ? | No |
| Primary Taxonomy | 276400000X Rehabilitation, Substance Use Disorder Unit |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 251B00000X Case Management | |
| 251S00000X | |
| Enumeration Date | 2020-09-10 |
| Last Update Date | 2022-02-11 |