| NPI | 1700313830 |
|---|---|
| Former Legal Business Name | GRAPEVINE RECOVERY ASSOCIATES LLC |
| Entity Type | Organization |
| Authorized Contact | KENNETH B SATROM CEO 301-708-9671 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2017-05-19 |
| Last Update Date | 2017-05-19 |