| NPI | 1205512431 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELIQUE MUHINGERWA Employee 346-758-4916 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2023-06-22 |
| Last Update Date | 2023-06-22 |