| NPI | 1609472075 |
|---|---|
| Other Name | IVAN QUAN |
| Entity Type | Organization |
| Authorized Contact | IVAN QUAN Owner 864-614-1407 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2020-12-10 |
| Last Update Date | 2022-11-30 |