NPI | 1356838700 |
---|---|
Doing Business As | VILLA MARIA SUD- FALLSTAFF LEVEL 1 |
Entity Type | Organization |
Authorized Contact | GLORIA OVERSMITH Billing Manager 667-600-2249 |
Organization Subpart ? | No |
Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
Enumeration Date | 2018-04-20 |
Last Update Date | 2020-01-03 |