| NPI | 1093587685 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JARED TURNER Billing Manager 772-812-9652 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 323P00000X Psychiatric Residential Treatment Facility | |
| Enumeration Date | 2023-10-26 |
| Last Update Date | 2025-01-28 |