| NPI | 1023946431 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES CODY CRAWFORD Executive Director 442-216-1187 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2026-05-13 |
| Last Update Date | 2026-05-13 |