| NPI | 1649649807 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMIL SIDHU Owner 866-805-0885 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2015-09-17 |
| Last Update Date | 2015-09-17 |