| NPI | 1750039715 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EUGENE LAWRENCE Director 888-407-4799 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2022-03-17 |
| Last Update Date | 2022-03-17 |