| NPI | 1295005155 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGIE GARRETT VP Of Operations 662-280-5758 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: TN I000000010003) |
| Enumeration Date | 2012-01-10 |
| Last Update Date | 2012-01-10 |