| NPI | 1932559705 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES JARVIS CEO 857-225-1998 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: FL 5001) |
| Enumeration Date | 2016-06-13 |
| Last Update Date | 2022-07-21 |