| NPI | 1215530225 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CORBIN LOFLIN President 888-672-6447 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 207LA0401X Anesthesiology Addiction Medicine |
| 207QA0401X Family Medicine Addiction Medicine | |
| 207RA0401X Internal Medicine Addiction Medicine | |
| 2083A0300X Preventive Medicine Addiction Medicine | |
| 2084A0401X Psychiatry & Neurology Addiction Medicine | |
| 2084P0802X Psychiatry & Neurology Addiction Psychiatry | |
| 251S00000X Community/Behavioral Health | |
| 261QM1300X Clinic/Center Multi-Specialty | |
| Enumeration Date | 2020-11-20 |
| Last Update Date | 2020-11-20 |