NPI | 1326680422 |
---|---|
Entity Type | Organization |
Authorized Contact | DARIAN ZIMA CFO 712-256-7888 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
Additional Taxonomies | 103TP2701X Psychologist, Group Psychotherapy |
Enumeration Date | 2019-10-10 |
Last Update Date | 2019-10-10 |