| NPI | 1417668237 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER DANIEL NELSON Owner 774-893-3253 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2022-12-13 |
| Last Update Date | 2022-12-13 |