| NPI | 1992469365 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN DESCOTEAUX Pc Owner 508-246-2202 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2021-10-22 |
| Last Update Date | 2022-01-28 |