NPI | 1104698422 |
---|---|
Entity Type | Organization |
Authorized Contact | MICHAEL KEENAN Executive Director 435-680-1459 |
Organization Subpart ? | No |
Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
Enumeration Date | 2023-10-30 |
Last Update Date | 2024-09-24 |