| NPI | 1447873039 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEEANNE CROWSON Owner 501-904-8711 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YP2500X Counselor, Professional | |
| 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) | |
| Enumeration Date | 2020-05-18 |
| Last Update Date | 2020-05-18 |