| NPI | 1477959385 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN ROSS CEO 917-903-7445 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: AZ OTC6880) |
| Enumeration Date | 2014-11-05 |
| Last Update Date | 2023-01-13 |