| NPI | 1497327720 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN DENKER Member 229-560-8634 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 261QR0800X Clinic/Center, Recovery Care |
| Enumeration Date | 2021-07-15 |
| Last Update Date | 2022-06-24 |