PREMIER DETOX SERVICES LLC

Registered Nurse — Addiction (Substance Use Disorder)

Code: 163WA0400X

Meals

Code: 174200000X

Case Management

Code: 251B00000X

Home Infusion

Code: 251F00000X

Nursing Care

Code: 251J00000X

In Home Supportive Care

Code: 253Z00000X

Private Vehicle

Code: 347C00000X

Clinic/Center — Rehabilitation, Substance Use Disorder

Code: 261QR0405X