NPI | 1497258784 |
---|---|
Entity Type | Organization |
Authorized Contact | LESLIE HOLLAND Executive Director/Owner 256-739-5595 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic (Licence: AL 1195) |
Additional Taxonomies | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: AL 112206) |
251S00000X (Licence: AL 1195) | |
261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: AL 1195) | |
Enumeration Date | 2018-03-13 |
Last Update Date | 2018-03-13 |