NPI | 1083141600 |
---|---|
Entity Type | Organization |
Authorized Contact | BRUCE JARVIE VP, Treasurer 214-379-3300 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
Additional Taxonomies | 261QM2800X Clinic/Center, Methadone Clinic (Licence: VT ADAP) |
Enumeration Date | 2017-05-13 |
Last Update Date | 2024-07-29 |