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General NPI Number Information
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NPI Number | 1801544424
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Entity Type | Organization
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Legal Business Name | ATTACK ADDICTION FOUNDATION
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Dates
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Enumeration Date | 03/14/2022
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Last Update Date | 03/14/2022
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Provider Practice Location Address
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Address Line | 22703 HURDLE DITCH RD
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City | HARBESON
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State | DE
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Zip | 19951-2931
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Country | US
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Telephone | 302-000-0000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 36
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City | BEAR
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State | DE
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Zip | 19701-0036
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | BOARD MEMBER
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Name | DON KEISTER
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Credential |
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Telephone | 320-723-1992
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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