| NPI | 1700573060 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ISAAC GRANT Manager 725-270-9819 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 261QM0850X Clinic/Center Adult Mental Health |
| 261QR0800X Clinic/Center Recovery Care | |
| Enumeration Date | 2023-04-18 |
| Last Update Date | 2023-04-18 |