| NPI | 1407610215 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT WILLIAM DAUGHENBAUGH Administrator 026-730-5206 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2024-02-12 |
| Last Update Date | 2024-02-12 |