| NPI | 1346731171 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUPERT MCCORMAC Chief Executive Officer 800-805-6989 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 207LA0401X Anesthesiology, Addiction Medicine |
| 251S00000X | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM2800X Clinic/Center, Methadone Clinic | |
| 261QP2300X Clinic/Center, Primary Care | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2018-05-29 |
| Last Update Date | 2025-02-24 |