| NPI | 1871099481 |
|---|---|
| Doing Business As | MEDMARK KENTWOOD |
| Entity Type | Organization |
| Authorized Contact | BOND ANDREWS VP, Rcm 214-379-3379 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 261QM2800X Clinic/Center Methadone |
| Enumeration Date | 2018-04-03 |
| Last Update Date | 2019-02-20 |