| NPI | 1083094858 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SEAN CALLAHAN Account Specialist 800-999-9755 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2015-06-05 |
| Last Update Date | 2015-06-05 |