Provider Demographics
NPI:1801544424
Name:ATTACK ADDICTION FOUNDATION
Entity type:Organization
Organization Name:ATTACK ADDICTION FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:DON
Authorized Official - Middle Name:
Authorized Official - Last Name:KEISTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:320-723-1992
Mailing Address - Street 1:PO BOX 36
Mailing Address - Street 2:
Mailing Address - City:BEAR
Mailing Address - State:DE
Mailing Address - Zip Code:19701-0036
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:22703 HURDLE DITCH RD
Practice Address - Street 2:
Practice Address - City:HARBESON
Practice Address - State:DE
Practice Address - Zip Code:19951-2931
Practice Address - Country:US
Practice Address - Phone:302-000-0000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-14
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder