NPI | 1053015438 |
---|---|
Entity Type | Organization |
Authorized Contact | JARED TURNER Billing Manager 772-812-9652 |
Organization Subpart ? | No |
Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
261QM0850X Clinic/Center Adult Mental Health | |
324500000X Substance Abuse Rehabilitation Facility | |
Enumeration Date | 2023-03-29 |
Last Update Date | 2024-04-18 |