| NPI | 1780053173 |
|---|---|
| Doing Business As | MADISON TEEN RECOVERY CENTER |
| Entity Type | Organization |
| Authorized Contact | JEANNE AUDREY MCALISTER Founder And CEO 619-442-0277 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2015-09-16 |
| Last Update Date | 2019-11-19 |