| NPI | 1407158215 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MURIEL LARAMORE Program Director 267-304-1649 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2010-11-30 |
| Last Update Date | 2010-11-30 |