| NPI | 1922630912 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCY PATEL Owner 864-400-8293 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Additional Taxonomies | 207RP1001X Internal Medicine Pulmonary Disease |
| 261QM1300X Clinic/Center Multi-Specialty | |
| Enumeration Date | 2020-02-07 |
| Last Update Date | 2022-12-20 |