| NPI | 1205388527 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT NIZNIK CEO 855-370-4462 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| Enumeration Date | 2016-11-03 |
| Last Update Date | 2021-11-03 |