| NPI | 1952898330 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACEY K BORDEN Founder/Sud Counselor 857-237-2780 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MA 14960) |
| Additional Taxonomies | 251B00000X Case Management (Licence: MA 14960) |
| 251S00000X (Licence: MA 14960) | |
| Enumeration Date | 2018-04-20 |
| Last Update Date | 2018-08-17 |