| NPI | 1073196465 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BONITA MCMORRIS CEO 667-802-5335 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2021-05-03 |
| Last Update Date | 2023-05-25 |