NPI | 1225570195 |
---|---|
Entity Type | Organization |
Authorized Contact | RUPERT J. MCCORMAC President 800-805-6989 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X Community/Behavioral Health |
Additional Taxonomies | 261QM0801X |
261QM1300X Clinic/Center, Multi-Specialty | |
261QM2800X Clinic/Center, Methadone Clinic | |
261QP2300X Clinic/Center, Primary Care | |
261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
Enumeration Date | 2016-11-09 |
Last Update Date | 2022-06-18 |