| NPI | 1194438465 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER COLLINS Executive Director 102-515-1954 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2023-01-03 |
| Last Update Date | 2025-08-08 |