NPI | 1003885146 |
---|---|
Entity Type | Organization |
Authorized Contact | DEBRA K DANIELS Program Billing Specialist 386-842-5501 |
Organization Subpart ? | No |
Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
Enumeration Date | 2006-03-14 |
Last Update Date | 2020-08-22 |