| NPI | 1376911495 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZAID FADUL CEO 855-360-4673 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health |
| 261QP2300X Clinic/Center, Primary Care (Licence: OH 35.122879) | |
| Enumeration Date | 2015-09-05 |
| Last Update Date | 2016-07-12 |