| NPI | 1235999681 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TODD J HASSON Revenue Cycle Manager 234-239-5999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2024-03-21 |
| Last Update Date | 2024-11-13 |