| NPI | 1467501544 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHYLISS JOHNSON Director Of Operations 1800-344-6423 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MD 16295) |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2020-08-22 |