| NPI | 1538532031 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEVON Z HICKS Director 302-377-2358 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2015-11-05 |
| Last Update Date | 2020-11-30 |