| NPI | 1770824526 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMISON DEREK FERAMSICO Medical Director 800-474-4059 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2013-03-04 |
| Last Update Date | 2013-03-04 |