| NPI | 1861892101 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY STRUVE President 800-994-3751 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: AZ OTC6755) |
| Additional Taxonomies | 261QM0801X (Licence: OTC6755) |
| Enumeration Date | 2014-08-22 |
| Last Update Date | 2016-08-12 |