| NPI | 1346320983 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNN M FAHEY CEO 302-225-9269 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 261QM2800X Clinic/Center, Methadone Clinic | |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2022-09-27 |