NPI | 1174521488 |
---|---|
Doing Business As | PROVIDENCE COMPREHENSIVE TREATMENT CENTER |
Entity Type | Organization |
Authorized Contact | BRIAN PHILLIP FARLEY VP & Secretary 615-716-9335 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic |
Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: RI 608) |
261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: RI 608) | |
Enumeration Date | 2005-07-11 |
Last Update Date | 2025-04-14 |