| NPI | 1609363175 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN ANTHONY ROBILIO Owner 888-403-6446 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder (Licence: FL 1018009) |
| Additional Taxonomies | 103TP2701X Psychologist Group Psychotherapy |
| Enumeration Date | 2018-04-19 |
| Last Update Date | 2019-06-11 |