| NPI | 1548034085 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINE STATES Director Operations And Compliance 800-288-2818 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2023-11-14 |
| Last Update Date | 2023-11-14 |