| NPI | 1104398460 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEAU HUNTER EAVES CFO 870-273-2096 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility Substance Abuse Treatment, Children |
| Enumeration Date | 2018-12-27 |
| Last Update Date | 2018-12-27 |