| NPI | 1336734912 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE GARRISON Credentialing And Billing Represent 888-222-7008 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0800X Clinic/Center, Recovery Care |
| Enumeration Date | 2021-03-04 |
| Last Update Date | 2021-03-04 |