| NPI | 1609985563 |
|---|---|
| Other Name | VA |
| Entity Type | Organization |
| Authorized Contact | SUSAN J STEVENSON Addiction Therapist/Prg Coordinator 501-257-3204 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 1455) |
| Additional Taxonomies | 283Q00000X Psychiatric Hospital |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2020-08-22 |