| NPI | 1467122051 |
|---|---|
| Doing Business As | R. MIGUEL MAGALLANEZ LCSW |
| Doing Business As | ANTIDOTE RECOVERY |
| Entity Type | Organization |
| Authorized Contact | ROBERTO MIGUEL MAGALLANEZ CEO 812-624-1180 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 171M00000X Case Manager/Care Coordinator | |
| 175T00000X Peer Specialist | |
| Enumeration Date | 2021-09-15 |
| Last Update Date | 2021-09-15 |