NPI | 1003413097 |
---|---|
Other Name | PROVIDENCE TREATMENT |
Doing Business As | PROVIDENCE TREATMENT |
Entity Type | Organization |
Authorized Contact | WILLIAM J HERAN CEO 808-445-6780 |
Organization Subpart ? | No |
Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
Enumeration Date | 2020-10-03 |
Last Update Date | 2021-05-07 |