| NPI | 1134405145 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER W GURESKY President/Medical Director 870-774-0421 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic |
| Enumeration Date | 2011-10-24 |
| Last Update Date | 2023-11-30 |