| NPI | 1992252886 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN SINGER Manager 754-209-1009 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2016-09-08 |
| Last Update Date | 2016-09-08 |