| NPI | 1417311507 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALPHONSO BROWN President/Medical Director 339-205-2508 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RA0401X Internal Medicine Addiction Medicine (Licence: MA 152241) |
| Enumeration Date | 2016-04-05 |
| Last Update Date | 2016-04-05 |