NPI | 1265004873 |
---|---|
Former Name | CARO CHAMBERS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: IL 35337) |
Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: IL 35337) |
Enumeration Date | 2021-07-13 |
Last Update Date | 2021-07-13 |