| NPI | 1205312766 |
|---|---|
| Doing Business As | KWENYAN PROFESSIONAL HEALTH SERVICES, LLC |
| Other Name | KWENYAN PROFESSIONAL HEALTH SERVICES, LLLC |
| Entity Type | Organization |
| Authorized Contact | DR. DANIEL ESTRADA CASSELL, PH.D., MPH President/CEO: Administrator 215-432-3702 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: NJ 2000686) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NJ 2000686) |
| Enumeration Date | 2018-07-17 |
| Last Update Date | 2018-07-17 |