| NPI | 1386230258 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JARED PRUZAN Executive 800-411-8019 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2020-12-15 |
| Last Update Date | 2020-12-15 |