| NPI | 1841846615 |
|---|---|
| Doing Business As | PGIC INC |
| Entity Type | Organization |
| Authorized Contact | IMMACULA SAINT LOUIS Medical Director 667-401-5936 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2019-08-16 |
| Last Update Date | 2022-06-07 |