| NPI | 1740872696 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRACE GITAU Hr 774-312-1810 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 261QM0801X | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2021-02-10 |
| Last Update Date | 2021-02-10 |