| NPI | 1942604004 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW FRIIS Owner 754-222-6884 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: FL 1706AD953702) |
| Enumeration Date | 2014-10-20 |
| Last Update Date | 2014-10-20 |