| NPI | 1821515370 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMIL IGWENAGU Manager 774-253-0123 |
| Organization Subpart ? | No |
| Primary Taxonomy | 343800000X Secured Medical Transport (VAN) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 103TC1900X Psychologist, Counseling | |
| Enumeration Date | 2017-08-25 |
| Last Update Date | 2022-07-21 |