An internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine.
| Specialty | Taxonomy Code | |
|---|---|---|
| * | Addiction Medicine | 207RA0401X |
| Addiction (Substance Use Disorder) | 103TA0400X | |
| Addiction Medicine | 2084A0401X | |
| Mental Health | 101YM0800X | |
| Social Worker | 104100000X |
* Indicates primary specialty
| NPI Number | 1629398433 |
| Legal business name LBN |
CLEANSLATE CENTERS, LLC |
| Authorized official | AMANDA WILSON - (OWNER) |
| Entity | Organization |
| Organization subpart | No |
| Enumeration date | 06/03/2010 |
| Last updated | 06/09/2010 - About 16 years ago |
| Sole proprietor1 | Not specified |
| Identifiers | n/a |
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.
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