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 |