NPI | 1568922441 |
---|---|
Entity Type | Organization |
Authorized Contact | COLIN BEATTY CEO 339-368-7696 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261Q00000X Clinic/Center |
Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) |
261QM0850X Clinic/Center, Adult Mental Health | |
261QM1300X Clinic/Center, Multi-Specialty | |
291U00000X Clinical Medical Laboratory | |
Enumeration Date | 2019-03-25 |
Last Update Date | 2019-05-29 |