| NPI | 1003471202 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCY A JENKINS Compliance Director 855-483-7800 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2019-05-03 |
| Last Update Date | 2019-05-03 |