| NPI | 1093377855 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA KELLEY-FREEMAN CEO 800-867-2395 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 261QM2800X Clinic/Center, Methadone Clinic |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children | |
| Enumeration Date | 2019-07-02 |
| Last Update Date | 2019-07-02 |