| NPI | 1528505112 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK R GARLICK Owner 712-522-4590 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: IA 001046) |
| Enumeration Date | 2017-01-20 |
| Last Update Date | 2017-01-20 |