| NPI | 1962915256 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEGHAN S DAVIS Owner/Employee 802-473-8421 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VT 151.0127112) |
| Enumeration Date | 2017-11-09 |
| Last Update Date | 2017-11-09 |