| NPI | 1306534797 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY MARTIN Managing Director 800-842-1598 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 251B00000X Case Management |
| 261QC1500X Clinic/Center, Community Health | |
| Enumeration Date | 2023-04-25 |
| Last Update Date | 2025-11-17 |