| NPI | 1760233779 |
|---|---|
| Doing Business As | OTP SUD |
| Entity Type | Organization |
| Authorized Contact | JENNIFER RUDNIK Credentialing Manager 719-423-1341 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2024-03-28 |
| Last Update Date | 2024-03-28 |