| NPI | 1205134319 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRETT IAN COHEN COO 800-388-5150 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: VA 748-02-029) |
| Enumeration Date | 2011-03-14 |
| Last Update Date | 2023-04-18 |