| NPI | 1316715055 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN PHILLIP FARLEY VP & Secretary 156-716-9335 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM2800X Clinic/Center Methadone |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2023-12-12 |
| Last Update Date | 2024-10-03 |