| NPI | 1871711804 |
|---|---|
| Doing Business As | PRIDE HEALTH SERVICES VERMONT |
| Entity Type | Organization |
| Authorized Contact | GODFREY NWOGENE Executive Director 310-677-9019 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 190212AN) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2009-05-07 |