| NPI | 1831598572 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA L GORDY Program Director, Administrator 478-232-7556 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine |
| Enumeration Date | 2014-08-19 |
| Last Update Date | 2014-08-19 |