| NPI | 1164074951 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHY ANNE WINGATE Treasurer & CFO 844-422-3632 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2019-07-11 |
| Last Update Date | 2019-07-11 |