| NPI | 1619356888 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN VECCIA COO/Managing Partner 772-800-3990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TA0400X Psychologist, Addiction (Substance Use Disorder) |
| Enumeration Date | 2015-05-21 |
| Last Update Date | 2015-06-05 |