NPI | 1508613795 |
---|---|
Former Legal Business Name | PROTEA HEALTH LLC |
Entity Type | Organization |
Authorized Contact | FARDOWSA HASSAN IMAN Clinical Director 320-420-4469 |
Organization Subpart ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical |
Enumeration Date | 2024-05-04 |
Last Update Date | 2024-05-04 |