NPI | 1942920533 |
---|---|
Entity Type | Organization |
Authorized Contact | ZACHARY JENSON CEO 385-352-9696 |
Organization Subpart ? | Yes |
Primary Taxonomy | 2083A0300X Preventive Medicine, Addiction Medicine |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
103TA0400X Psychologist, Addiction (Substance Use Disorder) | |
163WA0400X Registered Nurse, Addiction (Substance Use Disorder) | |
2084A0401X Psychiatry & Neurology, Addiction Medicine | |
Enumeration Date | 2022-09-01 |
Last Update Date | 2024-10-14 |