| NPI | 1063921047 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY LYNN THARP Billing Specialist Manager 302-629-2300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2017-09-22 |
| Last Update Date | 2021-07-29 |