| NPI | 1992106249 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON WHEELER Account Manager 954-802-9568 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NJ 44SW01474300) |
| Enumeration Date | 2014-09-05 |
| Last Update Date | 2014-09-05 |