| NPI | 1184110678 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEX LEE Clinical Director 888-315-0887 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2018-07-08 |
| Last Update Date | 2018-07-08 |