| NPI | 1659127256 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | XAVIER CABAN President 857-544-2776 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0800X Clinic/Center Recovery Care |
| Additional Taxonomies | 261QH0100X Clinic/Center Health Service |
| 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2024-04-25 |
| Last Update Date | 2024-04-25 |