NPI | 1336760222 |
---|---|
Entity Type | Organization |
Authorized Contact | DERRICK JOHNSON CEO 980-505-2353 |
Organization Subpart ? | No |
Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
Enumeration Date | 2020-05-01 |
Last Update Date | 2020-05-01 |