| NPI | 1447889829 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGIE NEWMAN Credentialing 888-395-0423 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Enumeration Date | 2020-04-07 |
| Last Update Date | 2020-04-07 |