| NPI | 1427368687 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATHEW CARVER Program Director 800-759-1930 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 261QA0600X Clinic/Center, Adult Day Care |
| Enumeration Date | 2010-10-20 |
| Last Update Date | 2010-10-20 |