| NPI | 1083296636 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLAS ADAM PETRILLO Owner/Cmo 888-979-9503 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2021-04-23 |
| Last Update Date | 2024-03-27 |