| NPI | 1457141939 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTHA SUSAN WARD Sole Member 229-233-6326 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2025-05-08 |
| Last Update Date | 2025-05-08 |