| NPI | 1114506003 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELANIE BISON Managing Member 725-222-9502 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 101YM0800X Counselor Mental Health | |
| Enumeration Date | 2021-04-07 |
| Last Update Date | 2021-04-07 |