| NPI | 1518506781 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLINE REED Member 740-804-1526 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 207Q00000X Family Medicine | |
| 207R00000X Internal Medicine | |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 251S00000X | |
| Enumeration Date | 2020-01-05 |
| Last Update Date | 2020-01-05 |