| NPI | 1104498419 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDRE HALEY Owner 302-563-8399 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 251S00000X |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2021-07-15 |
| Last Update Date | 2024-05-16 |