| NPI | 1518447309 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMABEL PIRIS Practice Manager 765-771-7108 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2018-08-21 |
| Last Update Date | 2019-03-11 |