NPI | 1518429612 |
---|---|
Entity Type | Organization |
Authorized Contact | KEVIN MELLO President 800-762-6717 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261Q00000X Clinic/Center |
Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
261QR0400X Clinic/Center, Rehabilitation | |
261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
Enumeration Date | 2019-04-05 |
Last Update Date | 2020-02-14 |