| NPI | 1508439910 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA KAPLAN Counselor & Program Director 662-510-2523 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083A0300X Preventive Medicine, Addiction Medicine |
| Enumeration Date | 2021-07-22 |
| Last Update Date | 2021-07-22 |