| NPI | 1063244135 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI KOLIN Authorized Official 877-959-8180 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 261QM0850X Clinic/Center Adult Mental Health |
| Enumeration Date | 2024-08-16 |
| Last Update Date | 2024-08-16 |