| NPI | 1033737762 |
|---|---|
| Doing Business As | RETREAT AT SKYRIDGE |
| Entity Type | Organization |
| Authorized Contact | DARREN WAYNE DAVIS CEO 877-419-3005 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2020-07-09 |
| Last Update Date | 2020-07-09 |