| NPI | 1639910003 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SILVIA M SEVER Credentialing & Billing 239-878-7895 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2024-06-01 |
| Last Update Date | 2024-07-12 |