| NPI | 1477981587 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DUSTY R BUFORD Counslor 909-433-9824 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2013-10-29 |
| Last Update Date | 2013-10-29 |