| NPI | 1003324625 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WHITNEY MCMILLAN Director Of Operations 863-532-3151 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2018-01-17 |
| Last Update Date | 2020-09-22 |