| NPI | 1083178289 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA MARIE UNDERHILL Clinician 475-422-4361 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2019-01-22 |
| Last Update Date | 2019-02-07 |