| NPI | 1013553247 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIKKLE LEE HAMPTON President 606-516-9939 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2019-11-22 |
| Last Update Date | 2024-09-19 |