| NPI | 1003507278 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHTON JAYLEE KELLEY CEO 479-685-7374 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 261QM0850X Clinic/Center Adult Mental Health | |
| 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2023-05-17 |
| Last Update Date | 2023-05-17 |